Wednesday, August 28, 2013

Medical Costs

Do NOT get sick in the United States.
It's too expensive!!

I'm one of the lucky ones that has Health Insurance, well... I wouldn't say "Luck" played too much into it, as I had to EARN my education and therefor qualify for a good job that would offer me good benefits.

I have been in the position of not having Health Insurance though. Last year when I moved from San Antonio to Austin, I couldn't work, I had a broken leg and it took me a few months to get back on my feet. As soon as I was able I looked for work, and was eventually hired.

Without health insurance it can be a brutal thing, the bills come in and they aren't gentle. If you don't have health insurance you'll get the very very basics of care IF you're lucky to get any care, and that's only in an emergency situation, I don't know of any Doctors that take patients with no Insurance. Of course you always hear about those inner city places that help homeless people, but I don't have any idea about how they work.

When I was without insurance my monthly medication (Effexor) cost $90 a month. That's $3 a tablet. I take Effexor because it's the best thing I have been treated with that helps with panic attacks, since I have been on Effexor (over 7 years now) I have not had one single panic attack, so I don't even think about NOT buying it.

I do understand that health care in the UK is free, but what does "Free" entail? I know of people in the UK that have to wait weeks for procedures that we can schedule within days in the States.... the same day or next day if it's urgent. I know people in the UK that have had to have just simple anti-biotics but couldn't get in to see their Doctors for a week! A whole week. But then... I would rather wait a week, than to not have a Doctor at all...

There are so many good and so many bad factors that play into health care in the USA and the UK. I think that the pharmaceutical companies have a lot of control over things in the USA and I also know that there are a lot of medications available sooner in Europe than in the USA because of our FDA (US Food and Drug Administration).

Okay after all that blather, what I really wanted to share...

Do you remember at the beginning of the month when I had Strep Throat? It was a Saturday and I had a fever and could no longer take the pain so I went to the ER...

I received notice from my Insurance Company.

Medical Emergency Drugs (2 tablets of Basic Pain Killers that you can buy in any store):
Amount Billed: $12 That's $6 for a tablet? Really??
Amount Not Covered by Ins Company: $1.02
Amount Covered by Ins Company: $10.98

Laboratory Services:
Amount Billed: $243
Amount Not Covered by Ins. Company: $20.83
Amount Paid By Ins. Company: $222.17

Use of Medical Emergency Room: (I was there just over an hour)
Amount Billed: $900
Amount Not Covered by Ins. Company: $77.15
Amount Paid By Ins. Company: $822.85

Total Billed $1,155
Amount Not Covered by Ins. Company $99.00
Amount Paid By Ins. Company $1065
My Copay Amount at time of visit $100
My Coinsurance Amount $44.43 (I have no idea what this is, I plan to call them)

AND THE DOCTOR BILLED ME SEPARATELY!

Medical Emergency Care from Doctor: (All she did was stick a swab in my mouth).
Amount Billed $652. (FOR 10 FECKING MINUTES OF HER TIME?!?!?!)
Amount NOT Covered by Ins. Company: $420.97
Amount Covered By Ins. Company: $231.03 (Apparently they think the Doctor is taking the piss).

Any costs not covered by my Insurance company I'm liable for, but sometimes the hospital will bill you a discounted amount, which I hope is true, as of right now, my insurance company says I'm responsible for over $500 worth of my bill!

The hospital has yet to bill me. So time will tell. This is only notification from my Insurance company on what they are paying.

Aye aye aye!!

On a happier note. I LOVE my new school, the students are awesome! I love being around these teenagers, this year I'm working with 3 Down Syndrome kids. I've never had the privilege of working with kids that have this disability and HELLO... these kids ROCK, they are always so happy... Love it! But they are only a small part of my day... I wish I had them more than 45 minutes... I could just eat them up with a spoon!

Tammy x

11 comments:

  1. Free healthcare may not offer everything that paid-for healthcare does. As medicine has got more complex and more expensive treatments and drugs have come on the market, it gets harder to give everyone optimum treatment for free. Having said that you can of course take out health insurance over here if you want to have access to treatments that are not available on the NHS. Usually these are things like physio which is pretty poor on the NHS. I think mental health and long term maintenance for common conditions is not that great on the NHS. Once you take the private route though you have to stick with private hospitals and cannot dip in and out of the NHS afterwards. This can be a problem if you hit the limit of your cover.

    I have a low cover of private insurance in case I want a private room, etc. and I know some people prefer to have private midwives as the NHS system is a bit of a cattle market! I might use it if I needed surgery and wanted a particular doctor and hospital (although there is an element of patient choice in the NHS). It sometimes gets quicker treatment for non emergency conditions. You do have to pay for your own drugs with private healthcare here.

    The reason I have it is that it would buy more comfortable surroundings and better food, and better aftercare (until I hit the limit) and just genearlly make me feel a bit more in control. That would matter to me. Most people don't have it though.

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  2. You do hear about waiting lists on the NHS and problems getting in to see a doctor, but I don't think I'd have had any better care when I had Cancer if I'd had private insurance. I was in hospital for two months, then two further stays as an inpatient. There was no waiting around for any treatment and I was treated so well. I've had doctor's receptionists tell me there's no appointments available over the years, but they soon back down when I stand my ground and insist that I'm seen. I've heard some horror stories about the NHS, but it literally saved my life so I can't say a bad word about it.

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  3. Ooooh owch, that's a lot of money for a throat swab!

    I'm really grateful for the NHS, free healthcare is nice, and when I was younger I had 8 years of orthodontic work on the NHS as well as free prescriptions for my inhalers (have to pay now though but it's only £7.50 per prescription!). I have experienced long waiting times for hospital outpatient appointments for non-emergencies, but both times when I needed hospital tests as an emergency I was seen within a couple of days. I think it also depends which Doctors surgery you're registered at. I recently changed to a new GP surgery as you couldn't get an appointment, even an emergency appointment for 2 weeks. At my new one they ask you when would be convenient or you can go without an appointment and wait to see the 'walk in' doctor, it is fab! You'll find out when you come over here! :)

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  4. Tammy, You can see why poor people just suffer or die...who can afford that over priced care. I always keep Tylonal, cold meds, cough drops, ice packs, heating pad....things I can treat myself with when I have too. I have insurance and a secondary insurance and still pay deductable and some out of pocket. Sad. I wish you good health honey. Our health is so very important. xoxo,Susie

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  5. I FEEL YOUR PAIN AND ALTHOUGH WE ARE LUCKY IN CANADA, LIKE YOU WE DO NEED HEALTH INSURANCE HERE OTHERWISE THINGS COST SO MUCH.

    GILL

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  6. Wow - that's quite a bill!!! Health provision through the NHS in the UK is rather variable. It appears that some areas are better run than others and this results in a better patient experience too. We never see bills of those proportions though - so I suppose we shouldn't complain!!!! Jx

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  7. We have both "free healthcare" and insurance. Luckily with Mike and him working for Dell, they pay for most of our insurance, he pays some each month in his pay packet, and it covers our whole family. I wouldn't wait a day on the public system in Ireland, once I flash the insurance card you get in almost immediately. The public health service here is a joke.

    Thankfully I have a generally healthy family but the parents who I work for... well all their kids are diagnosed with an ASD and the services available to them are minuscule at best and joke worthy!! It's a shame. The cost of medication here is choronic, even over the counter basics... I paid €8 for a 250ml bottle of pediatric ibuprofen the other week! I paid €126 for a 10 minute trip to the doctor + antibiotics for Dolly (health insurers won't cover medicine or GP visits here)only to find out (AFTER she'd taken the tablets) she's allergic to penicillin and had to pay another €120 for a GP revisit and new antibiotics.

    Health insurance is the best thing to have. I wouldn't be without ours... even if we don't use it often. I know it's there for us. Keep well Tammy x

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  8. If it is an emergency the NHS generally treat you straight away. If it is non-life threatening you have to wait, but I think 16 weeks is the limit for an operation - again it'll be quicker if urgent.
    I've needed 2 ops and both times my experiences were good (apart from having to have the op in the first place.) First one I was discharged the same day, last time I had to stay overnight but was given a private room with private en-suite. I think I was lucky there though.

    My GP surgery is pretty good, if you want to see a particular Dr and it isn't an emergency you may have to wait a couple of weeks. For anything urgent you'll be seen the same day, but you can't chose which Dr - one of them will be designated to be the Dr for the day for emergency appointments.

    Oh and don't even think about going to A&E for anything other than an emergency - ie life threatening, broken bones, needing stitches etc as you'll be turned away for anything minor and referred to your GP or a walk in centre (which treat non emergencies - you just sit and wait, depending on the day and time it could be a few hours.)

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  9. I don't know much about the NHS or other "free" healthcare but I am sure it must have its drawbacks too. I've heard of people having to be on long waiting lists, especially in Canada. That said, I agree that our healthcare costs are pretty crazy in the US. We've always had decent coverage through my husband's work; it's not terrific but it really isn't too bad. I hope that something changes soon because there are a lot of people here who can't get the care they need. I'm glad to hear that you're enjoying your new job! I've worked with special needs kids, both as a teacher and as a TA (including 1:1 health aide), and I mostly enjoyed my DS kids a lot. :)

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  10. Gosh that's a lot to pay Tammy, and that's with insurance?! You do hear bad things about our NHS but I've never had a problem, although luckily never had a serious condition. I've had 3 c-sections all with very good care and numerous bad throats, ear infections etc.
    I also have an underactive thyroid which requires a daily pill, this is all free as are the blood tests to monitor it.
    Our doctors surgery has a system which enables you to almost always get an appointment on the day you telephone so that's great too.

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  11. Like others have said, I think it varies as to what area of the UK you are in. I have to say that already, I'm struggling with liking the NHS. Luckily, we have the ability to use both NHS or private, but our company wants us to use NHS first. I was hit with a very bad sinus infection in April, but every time they checked me at the walk in clinic that I had to go to because we newly moved to the UK and weren't established with a doctor, they said my throat and ears were clear, wait it out, it will go away. IT DIDN'T and I suffered for a month and had a disagreeable nurse who wanted to argue at how bad antibiotics are for you. I finally got over it when a friend gave me some antibiotics they'd picked up in India! The next time they went back to India, I had them pick me up some extra antibiotics for me so I can just treat myself in the future if necessary!
    I told a colleague that I feel the medical care here is going to be my biggest culture shock. She said "Yes, it will be!"
    I don't mean to knock it. I know it's been good for some. Unfortunately I had a terrible first experience which has left a really bad taste in my mouth that I'm not sure I'll ever be able to get past along with the many crazy stories from friends I've heard.
    Honestly, I prefer the medical care in the US. It's not perfect, it's expensive. I've just been fortunate to always have coverage.

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Thank you for your positive comments!