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Healthcare in the US

  1. Dec 5, 2015 #1
    I wanted to ask about the healthcare in the USA for a long time. From what I saw in movies and read in various articles or blogs it seems to me that many people can't afford it. Or that if you get ill and go to hospital, than you have to spend all your life savings on bills?
    What happens if poor people get cancer, for example? Do they get help if they can't afford the treatment?
     
  2. jcsd
  3. Dec 5, 2015 #2
    Traditionally, poor people often qualified for a program called "medicaid" in the USA. With the recent Obama health care plan, medicaid-based coverage has expanded significantly. Prior to this, to be poor and without health coverage meant bad times. Typically, health care coverage for the severely disaffected meant frequent trips to the "ER" (emergency room), which by law everyone was allowed.
     
  4. Dec 5, 2015 #3

    fresh_42

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    I've heard of a hospital - I think it was somewhere around Virginia - which opened a department for minor injuries, vaccinations and so on aside their ER which was at no costs to the public. They actually saved money by this!
     
  5. Dec 5, 2015 #4
    Fresh, so you normally have to pay even for vaccinations? Aren't they compulsory and a matter of something like national interest? Here, parents are visited by social workers and they have to pay fines if they refuse to have their children vaccinated for free (anti-vaccination philosophy is becoming a "first world" issue, but that's another story :) )
     
  6. Dec 5, 2015 #5
    You can help us out by specifying where "here" is. That way, we can check out and qualify your assertions and perhaps contribute supplementary data.
     
  7. Dec 5, 2015 #6

    fresh_42

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    No, I don't think so. But - as far as I know, since I'm a "European communist" like you when it comes to American healthcare :wink: - they saved the money by release their (very expensive) ER. It was even cheaper to give away minor medical care than it was when usually all those patients flood the ER as only possibility to get health care at no costs.
     
  8. Dec 5, 2015 #7

    SteamKing

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    Just because something is compulsory doesn't mean you get it for free.
     
  9. Dec 5, 2015 #8
    "here"- Slovakia
     
  10. Dec 5, 2015 #9
    well, of course, it doesn't have to mean that. But in our country everyone gets compulsory vaccinations (TBC, variola, rubeola, polio, "black cough" that have been used for decades. New generations are also vaccinated against hepatitis, and 13 pneumococcus infections- vaccine is called Prevenar13) for free. There are others, like against tick ( the insect) encephalitis you have to pay for, but those are voluntary.
    I thought this was the same everywhere.
     
  11. Dec 5, 2015 #10

    SteamKing

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    You may not be charged for getting a vaccination every time you show up at a clinic, but somewhere down the line, you pay for. Taxes, fees and other money paid to the government disguise the transaction, but it occurs regardless.

    Vaccines don't grow on trees; somewhere, someone has to make the vaccine and then distribute it, paying workers to produce and deliver it. I'm sure these workers like to get paid for their efforts and are not volunteering their time.

    Even in western Europe and the UK, much of the revenue derived from each country's value-added tax (VAT) goes to support various social services and health care, which the public thinks is provided without cost or at very little direct cost to them.

    It still costs real money to build a hospital, furnish it with medical equipment, and hire a staff to run it and care for patients. That money must come from somewhere; just because you don't get a bill with your name on it doesn't mean you aren't paying for it.

    Your government makes vaccinations compulsory because it doesn't like having raging epidemics of various diseases to deal with. It's a cost savings, because administering a vaccine is almost always cheaper than administering a cure (if one is available).
     
  12. Dec 5, 2015 #11
    Of course it's paid from taxes and/or insurance. Still, it somehow seems more fair if you don't have to pay for it directly because for poor people it might be too much to pay for it in cash.
     
  13. Dec 5, 2015 #12
    I'm not really qualified to comment on this because I don't have kids, but I don't think that parents have to pay to get their kids vaccinated in the USA. Again, I'm not really sure how this works, perhaps a parent of a young child in the USA could better elaborate.
     
  14. Dec 5, 2015 #13

    SteamKing

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    In the US, there are additional means to provide health care for the poor or the indigent. The Medicaid program is administered by the states for this type of care. In addition, some states run charity hospitals, and various religious orders operate hospitals as part of non-profit foundations set up to minister to the sick.

    In addition, according to federal law, no hospital can refuse to treat someone who comes to its emergency room for care, regardless of ability to pay for that care.
     
  15. Dec 5, 2015 #14

    russ_watters

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    The poor and uninsured have already been mentioned, but in any case, most people in the US have health insurance, so they don't pay much out of pocket if they get sick/get cancer.

    In the US:
    About 10% are not insured (they are not all necessarily poor - some choose not to be insured)*.
    About 55% are insured through their (or their partner's/parent's) jobs.
    About 15% are insured in private plans.
    About 37% are insured in government plans (old people, the military, government workers, the poor, etc.)
    http://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf
    (note, the numbers add up to greater than 100% because of overlapping plans)

    *My understanding is that "not insured" is only for medical specific insurance. If you are in a car accident, that is covered under car insurance. I went several years in my 20s without health insurance, by choice, with only car insurance, since by far the most likely cause of a serious medical issue for me would have been a car accident.
     
    Last edited: Dec 5, 2015
  16. Dec 5, 2015 #15

    meBigGuy

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    US health care rates poor for accessibility and not that good for plain quality. It is the clear winner for highest cost per capita. It's a travesty that US corporations make huge profits on poor health. It also incentivizes treating symptoms over curing causes. (BTW, I am in the US and have great, but expensive, health insurance)

    Merely looking at insurance coverage numbers doesn't really tell the story since many plans are $5000 deductible and have limited physicians. It's a travesty that many parents can't afford to take their child to a clinic to test for strep throat.

    One of many surveys:
    https://www.washingtonpost.com/news...least-effective-health-care-system-in-survey/

    One hidden example of corporate greed is the ultimate results of the Bayh-Dole Act in 1980 (which few know anything about) which allowed Corporations to buy University Drug Patents. The result is that instead of Universities licensing patents to many corporations, one corporation gets exclusive ownership and only pursues blockbusters. It also forces university research to focus on blockbusters. The story of the politics behind this reads like a joke, and the effects on the focus of university drug research have been devastating.

    The effect of for-profit corporate control on the US health system makes it more about money, and less about health.
     
  17. Dec 5, 2015 #16
    Where is this magical place you're talking about?

    Yes, you do have to pay for vaccinations, though the required shots are offered by the schools if you can't afford them.

    Except in the US, we pay several times what other countries pay for quality of care that isn't even close to what people in those countries are getting. Sure, either way you're still paying for it, either through taxes or through insurance payments, but in the US we have some of the most expensive healthcare in the world in terms of per capita expenditure (http://data.worldbank.org/indicator/SH.XPD.PCAP) despite vastly inferior quality of care.

    Plus, if the government takes $5000 from me to run a hospital, then I'm much happier than if an insurance company takes $5000 from me just so they can turn a profit.
     
  18. Dec 5, 2015 #17

    SteamKing

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    Maybe. In the UK, the government takes your taxes to pay for the NHS, and still, the doctors there are about to go on strike, just like any other government employee. Many drugs and treatments available in the US are not available in the UK NHS system, even with government footing the bill.

    Insurance companies, being private businesses, must turn a profit in order to remain in business. The government faces no such restraint, which is why public debt in many countries has exceeded supportable levels. The government spends more each year than it takes in from taxes and other revenues. Such a state of affairs can run for a while, maybe even many years, but eventually the laws of arithmetic win out.

    Someone, maybe your kids, maybe your grandkids, is going to take a big haircut financially.
     
  19. Dec 5, 2015 #18

    russ_watters

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    That doesn't tell the whole story either. I had a high deductible plan when I had a choice and would now if I could. I've gone years at a time without seeing a doctor, so a high deductible plan made more sense. The money doesn't just materialize out of thin air: if the insurance company is paying for it, someone has to be funding it. So if you have (for example) no deductible, that first $5,000 is paid for by higher premiums.
    I love how the title (and link) say "least effective" when the survey has a category titled "effective" in which the US ranks 3rd. :rolleyes:
     
    Last edited: Dec 5, 2015
  20. Dec 5, 2015 #19

    WWGD

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    Part of the problem in the U.S is having a disjointed system with different regulations in different states, unlike I think is the case with European and in general smaller countries, where you have more of a single, centralized system. Some of the recent trends are in Bioinformatics, the use and application of IT (Information Technology) in Healthcare, and the application in some subsystems of quality improvement methods (Six Sigma, agile methods for Project Management, etc.). Examples of this are Telehealth and Telemedicine, the remote administration of health .Some patients use PHRs, Personal Health Records, which are electronic compendiums, controlled by the individual, of a person's general healthcare information.
     
    Last edited: Dec 5, 2015
  21. Dec 5, 2015 #20

    SteamKing

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    The regulatory problem has only gotten worse since the passage of the ACA. Premiums are charged based on where the customer lives, not at the state level, but at the county level. If the county you live in has a higher incidence of disease than another county in the same state, there will be a premium differential charged for living in the 'unhealthy' area. Health insurance companies are still not permitted to operate across state lines, which further concentrates the risk.

    It's still not clear that applying more IT to medical care will generate the savings in health care costs that advocates hoped for initially. It does, however, raise the spectre that your personal medical and identity information will be at increased risk of being stolen or misused, since recent events have shown that even the US government is not immune to having the fingerprint and other personal data of its employees being stolen by hackers.

    http://www.reuters.com/article/us-usa-cybersecurity-fingerprints-idUSKCN0RN1V820150923

    And remember, once an IT system is installed, it's only a matter of time before it becomes obsolete. How many hospitals want to be involved in running sizable IT shops, rather than providing care to patients?
     
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