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British people react to American medical expenses

So I've learned that in other countries people don't get old, fat and die. That's how they keep health care cheap. Oh, and all their kids are born healthy - or they just let them die?

Anyway, story of the day from a friend of a friend. Second time I've seen this in recent years. Cost of an air ambulance? $25,000. No, it's probably not covered by your insurance. No, you probably won't find that out until after the ride. No, if you need one you're unlikely to be in the mindframe to check your insurance and even if you are you're unlikely to refuse it because if they're putting you or a loved one in one it means someone is near death. So.....ka-ching!
 
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I'd like to know more.

I just signed up for Medicare Advantage, and I am not a particularly healthy person. My out of pocket maximum is a little higher than if I went with a regular Medicare Supplement, but there are no premiums. So, in a normal year with a couple of doctor visits and some meds, I'll save some nice money. If I need some more expensive treatment, my max is more, but not that much more.

Plus, I can get reimbursement for some vision, dental and over the counter meds (like aspirin).

I spent several hours on this decision with a consultant, who was getting paid the same either way, and Medicare Advantage seemed like the way to go.

What am I missing?
All I know is that I had a platinum set up for five years with Medicare, and since I was still working my boss reimbursed my premiums. For 2020 my monthly costs were $212 for the supplement plus $72 for prescription coverage with a $500 deductible. That's in addition to the basic $135 deduction for basic Medicare I'm paying already. $419 a month on fixed income is a lot of money, plus since I'm healthy I don't make my scrip deductible until December so figure in another $500 for meds. About $5500 total.
I went with another plan where I now pay $47.90 a month and scrips are included - if I stay in network ( it's still a PPO) $0 co-pay for office, and specialists are $45. All my docs take the new plan. No need to change.
I went to the doc maybe 4 times last year, so $180 total out of pocket is affordable. Scrips are all generic and Tier 1 common so they're really cheap.
Now I just need to stay healthy, God willing.
 
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Googling obesity rates by country the United States is over 36%.

Europe is much lower. United Kingdom is highest around 28% with some countries under 20% (Italy).
 
I don't mind the idea of some sort of tax penalty for people who are purposefully in poor health. The problem is what should the measurement be? What could we measure on your body that gives an indication of overall health that can't also be affected by things outside of your control.

I'm more of an advocate of a sales tax, even a heavy sales tax on junk food. It's not perfect, but if we identify junk food as the cause of the problem the solution is to make the people who consume the most of it, pay a heavier burden. Honestly that sort of thing seems like the most fair way of doing it.
We have plenty of sin taxes in place - alcohol at $13.50 a gallon, cigarette taxes at a buck and a penny (plus state), even the sugar taxes cities such as Philly and Berkeley implemented a few years ago. Poor dietary and life choices can impact health costs, but until we see the data on the actual costs I'm not a fan of adding the tax. For example - cigarettes are a leading cause of lung cancer. It's also a leading cause of people dying before 65 and being ineligible for normal SS payments / Medicare. People die in hospitals every day - does the 55 year old that passes from lung cancer cost more if he/she didn't smoke and live to 75, after a hip replacement and other maladies that oft beset our older generations? Certainly it costs the private insurance of the employer a lot more - paid sick days, "smoke breaks", etc. But it costs the federal gov't a lot less.

Back to your original question, the biometric screening criteria needs the data along with the causation / correlation to drive the right incentives / penalties. One thing with a positive correlation to longevity is grip strength (for each sex). Cholesterol checks, blood pressure... we have the data. But it's noise until it affects the pocketbook for most of our population.

The US system is bad... and it's still better than most of the rest of the world if you have the finances. Privatized medicine has its place in this world. It's a lot easier to think this way as a typical HROT'er "have" vs the "have-nots".
 
That’s fine. Pick something. Any incentive to get people to lose weight has to save billions in the long run.

I don’t see why healthy people need to pay a tax just because they eat fast food. If they exercise enough to stay thin don’t punish them for eating a Big Mac.

Well they wouldn't pay much unless they ate a lot of fast food.

Lets acknowledge some issues with your ideas too. I'm not sure that any measurement could be an indicator independent of all health problems that are out of one's control. On top of that to pull that off someone is going to have to go in to be measured once a year and it will likely have to be done by someone who is not their doctor (as doctor's have a financial incentive to keep patients, they could fudge the numbers.)

On the other hand I acknowledge that making a big show of it and sending someone a check in the mail would probably be more effective than some tax savings that is going to seem very much like it's on paper. So I do find a certain attraction to your plan. But the bigger show we can make of it, the better. The people who get the checks should get them independently and if possible at a different time from tax refunds.

I would also say you would have to adjust your billing for wealth. But regardless I can get behind an idea that says that if our data shows that you are "purposefully unhealthy" you get a bill while if you are reasonably healthy within the choices you as an individual can make you get a check.
 
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Europeans get "free" health care because they pay a lot more in taxes - and they also dedicate a much larger portion of their budgets to health care. See, we've taken care of their defense for 75 years, so they don't have to spend big bucks on that. It's sad that we spend so much for their defense that we have folks here dying because they have no health care. And the waste in this country should be criminal.
Regardless, the NHS in Britain has serious challenges in delivering health care - but from what I read most Brits are satisfied overall.
I went shopping today for my Medicare Advantage/supplement plan today. I just hope I can stay healthy for a few more years.
Another one totally for hospital bills costing tens to hundreds of thousands of dollars. You cons are truly unbelievable. Every other civilized country does it right...but America can't...because people like you are brainwashed by the politicians who are paid by the healthcare racket in this country. Of all our issues, this is the one that boggles my mind...how people defend a racket that is ripping all of us off and has for years. They are desperate to keep ripping us off.
 
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Another one totally for hospital bills costing tens to hundreds of thousands of dollars. You cons are truly unbelievable. Every other civilized country does it right...but America can't...because people like you are brainwashed by the politicians who are paid by the healthcare racket in this country. Of all our issues, this is the one that boggles my mind...how people defend a racket that is ripping all of us off and has for years. They are desperate to keep ripping us off.
Who do you think should make less money for Americans to get cheaper healthcare ?

Do doctors and nurses need a pay cut?

Cutting insurance out would save some, I doubt as much as some think.

I would think drug companies could take a cut but will that be at the expense of research and newer / better drugs ? What percentage of newer pharmaceuticals come from the united states vs the countries that have cheaper healthcare ? Do those countries create and innovate like the United States?

I all for a better system but I would like to see the math in detail before I throw out my current situation. I don’t think that is too much to ask. In fact everybody should demand that.

two basic questions need to be addressed. Who profits too much from current system and who doesn’t pay enough.
 
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Googling obesity rates by country the United States is over 36%.

Europe is much lower. United Kingdom is highest around 28% with some countries under 20% (Italy).
Yes and smoking rates remain higher there, I believe.
I think one cancels out the other.
 
Another one totally for hospital bills costing tens to hundreds of thousands of dollars. You cons are truly unbelievable. Every other civilized country does it right...but America can't...because people like you are brainwashed by the politicians who are paid by the healthcare racket in this country. Of all our issues, this is the one that boggles my mind...how people defend a racket that is ripping all of us off and has for years. They are desperate to keep ripping us off.
You cons...people like you...brainwashed.
Laying groundwork for such civilized discourse.
Good job!
 
You cons...people like you...brainwashed.
Laying groundwork for such civilized discourse.
Good job!
Ummm...are you going to respond to the posts pointing out your falsehoods on health care spending in various countries. They were civil. Or just hope no one notices?
 
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You cons...people like you...brainwashed.
Laying groundwork for such civilized discourse.
Good job!

The thing is, respectfully I'm not sure how to respond to someone who claims "socialized medicine would never work" when we see it work everywhere but here.

Someone who insists we don't have the money when reality shows universal healthcare to be cheaper.

Who do you think should make less money for Americans to get cheaper healthcare ?

Do doctors and nurses need a pay cut?

Cutting insurance out would save some, I doubt as much as some think.

I would think drug companies could take a cut but will that be at the expense of research and newer / better drugs ? What percentage of newer pharmaceuticals come from the united states vs the countries that have cheaper healthcare ? Do those countries create and innovate like the United States?

I all for a better system but I would like to see the math in detail before I throw out my current situation. I don’t think that is too much to ask. In fact everybody should demand that.

two basic questions need to be addressed. Who profits too much from current system and who doesn’t pay enough.

Here is an idea with drug companies. What if we doubled the length of patents specifically for medical devices and drugs to make up for it? We change the system we allow the fed to negotiate with the drug companies to keep costs down and the drug companies stop fleecing Americans (And Americans alone) on prescription drugs in order to fund their research. Perhaps including language that only allows for a 50% markup in prices. In exchange the drug company gets a 30 year patent on new prescription drugs.

There would have to be other language that says they have to meet demand to keep the patent.

I would say that you might be over-estimating the cost of R&D. I looked up Pfizer for example and based off a couple articles taking the highest R&D cost number (8 billion) verses the lowest revenue number (53 billion) that comes out to only 15% of revenue is spent on R&D.

https://www.marketwatch.com/story/pfizer-to-raise-rd-spending-to-bolster-pipeline-2018-07-31

https://www.cnbc.com/2018/07/31/pfi...mates-on-higher-sales-of-prevnar-xeljanz.html

15% is of course significant but I would strongly argue that R&D alone is not the cause of the often massive markup we see on prescription drugs in this country. To be fair with net income at 7% of revenue neither is profit margin.
 
as long as you are healthy Advantage has advantages...sickly old farts like me, not so much. Once you start using the system, you will start getting charges. Just be careful. My experience has been a lot of folks don’t listen closely and then get burned because of their not paying attention. As long as you understand what you are getting.

Well, I think I do.

My maximum out of pocket in a year is only $300 more than if I went with Medicare + Supps, so I'm not sure how I could get burned. Do you know of a scenario that would cost me a bunch?
 
Who do you think should make less money for Americans to get cheaper healthcare ?

Do doctors and nurses need a pay cut?

Cutting insurance out would save some, I doubt as much as some think.

I would think drug companies could take a cut but will that be at the expense of research and newer / better drugs ? What percentage of newer pharmaceuticals come from the united states vs the countries that have cheaper healthcare ? Do those countries create and innovate like the United States?

I all for a better system but I would like to see the math in detail before I throw out my current situation. I don’t think that is too much to ask. In fact everybody should demand that.

two basic questions need to be addressed. Who profits too much from current system and who doesn’t pay enough.
Why are you okay with Americans being grossly overcharged for health care? There's always an excuse why we have to pay more...like your pharma example. That doesn't even make sense. Who gives a crap what company developed the drug? If it's 2 dollars in Sweden it shouldn't be 200 dollars here. It's a scam. Otherwise they wouldn't be lining politicians pockets to keep the prices up. That's the bottom line.
 
We are overcharged because we supplement other countries in a very large way. When the EU countries negotiate on drugs and refuse to pay the market rate, the cost simply gets raised in the US to make up for that. Most of the innovation in health care comes from the US because the money is here to take those risks. The failure rate is high in innovation and expensive....capping the successful products profits keep the ability to research down. Keep in mind as you watch this fun little video that anyone with money in the UK is not getting their more serious health needs met in the UK .. they come to the US for that.

If they were being honest they would include the amount of money that is paid by someone at their wage level for all taxes including their wonderfully regressive VAT

It's easy to sensationalize complicated issues... especially when one has an agenda.
 
We are overcharged because we supplement other countries in a very large way. When the EU countries negotiate on drugs and refuse to pay the market rate, the cost simply gets raised in the US to make up for that.

No. We get gouged because our elected officials allow us to be gouged.

Sure, if our Medicare were allowed to negotiate pricing, producers might increase what they charge elsewhere; the reality is they are not selling elsewhere "at a loss"; they are making profits on those sales.

Much of what we overpay goes to making all the ads you see on television.
 
Yes, healthcare costs and schemes are a disgrace. That said my recollection is that 10-15 years ago things weren’t as shitty as it is now.
 
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Why are you okay with Americans being grossly overcharged for health care? There's always an excuse why we have to pay more...like your pharma example. That doesn't even make sense. Who gives a crap what company developed the drug? If it's 2 dollars in Sweden it shouldn't be 200 dollars here. It's a scam. Otherwise they wouldn't be lining politicians pockets to keep the prices up. That's the bottom line.
My guess is the excess profits made in the United States fund research.

I am not saying I like it but every action will have an effect. To assume pharma will just take less money and it will not matter isn’t true.

I would like to see a law that doesn’t let hospitals and providers charge more because you have no insurance.

toilet paper cost the same at the store regardless of the consumers wealth. Healthcare should be the same.
 
Well, I think I do.

My maximum out of pocket in a year is only $300 more than if I went with Medicare + Supps, so I'm not sure how I could get burned. Do you know of a scenario that would cost me a bunch?
No...but that is your job, not mine. MY experience was that “advantage” was not to my advantage at all. Yours is yours. All are different.
 
20% chance of a severe learning disability = abortion? Yeah, you're a dick. And I could one-up your tale of woe in the NICU several fold, but I will spare you the details.
Yes and folks that go through extreme situations should never set the policy for everyone else. They lack objectivity.
 
Friends of ours just had a baby many weeks premature (weighed about a pound at birth but just went home this week weighing 8 pounds). Their bill so far...$500,000. Insurance will pay most but their bill will still be staggering. They make too much money to qualify for assistance so dad is contemplating quitting his job to cut their income so they can get help.
My son was born at U of I hospitals. Needed major open heart surgery at 5 days old and we were there almost 2.5 weeks. Our bill was around $250,000, but my insurance (Blue Cross) picked up all but $900. I experienced the beauty of insurance in that moment.
 
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My guess is the excess profits made in the United States fund research.

I am not saying I like it but every action will have an effect. To assume pharma will just take less money and it will not matter isn’t true.

I would like to see a law that doesn’t let hospitals and providers charge more because you have no insurance.

toilet paper cost the same at the store regardless of the consumers wealth. Healthcare should be the same.

Pfizer, as an example, spent about $8 billion on research and development in 2018. “Selling, informational, and administration” costs were $15 billion. Total revenue was $55.5 billion. They returned $12.7 billion to shareholders. The CEO had about $27 million in compensation.

So, your guess is wrong.
 
Pfizer, as an example, spent about $8 billion on research and development in 2018. “Selling, informational, and administration” costs were $15 billion. Total revenue was $55.5 billion. They returned $12.7 billion to shareholders. The CEO had about $27 million in compensation.

So, your guess is wrong.

Like I said: too much of the money is going to cute drug ads that are marketing directly to you.

Your numbers fully support that statement. They plug the money into the vehicle that allows them to dramatically overcharge for those drugs. Guarantee that "overseas" people don't see those same ads.
 
Like I said: too much of the money is going to cute drug ads that are marketing directly to you.

Your numbers fully support that statement. They plug the money into the vehicle that allows them to dramatically overcharge for those drugs. Guarantee that "overseas" people don't see those same ads.

America and New Zealand are the only countries that allow direct to consumer pharmaceutical marketing.
 
Europeans get "free" health care because they pay a lot more in taxes - and they also dedicate a much larger portion of their budgets to health care. See, we've taken care of their defense for 75 years, so they don't have to spend big bucks on that. It's sad that we spend so much for their defense that we have folks here dying because they have no health care. And the waste in this country should be criminal.
Regardless, the NHS in Britain has serious challenges in delivering health care - but from what I read most Brits are satisfied overall.
I went shopping today for my Medicare Advantage/supplement plan today. I just hope I can stay healthy for a few more years.

Ever heard of ACA? No one in this country 'has' to die because they have no healthcare.
Obamacare is still the law of the land because the Republican dominated Congress tried and failed to repeal ACA in 2017.

One can debate the premium cost per month for 'some' and debate coverages. Anyone who doesn't have healthcare have either made the choice to not...or cannot afford the monthly premiums.

How the Trump Administration has reshaped and restructured Affordable Care Act

https://iowa.forums.rivals.com/threads/british-people-react-to-american-medical-expenses.295345/

Be careful...Medicare Advantage is not the same as a Supplement Policy.
 
All I know is that I had a platinum set up for five years with Medicare, and since I was still working my boss reimbursed my premiums. For 2020 my monthly costs were $212 for the supplement plus $72 for prescription coverage with a $500 deductible. That's in addition to the basic $135 deduction for basic Medicare I'm paying already. $419 a month on fixed income is a lot of money, plus since I'm healthy I don't make my scrip deductible until December so figure in another $500 for meds. About $5500 total.
I went with another plan where I now pay $47.90 a month and scrips are included - if I stay in network ( it's still a PPO) $0 co-pay for office, and specialists are $45. All my docs take the new plan. No need to change.
I went to the doc maybe 4 times last year, so $180 total out of pocket is affordable. Scrips are all generic and Tier 1 common so they're really cheap.
Now I just need to stay healthy, God willing.

if I may ask...what does your HMO plan pay for hospital stays?
 
Yes and folks that go through extreme situations should never set the policy for everyone else. They lack objectivity.
Since Big Del never responded and you agree a 20% chance of a severe learning disability warrants death, let me pose some questions to you. In the calculus of whether a life is worth living, how much do the surviving 4 contribute to society, on average, during their lifetimes? Is the cost avoided by killing one baby in 5 offset by the value produced by the other 4 you decided not to kill? If your wife was pregnant, what is the probability of having a child with severe learning disabilities before you would terminate? What is the cutoff for medical cost for birth complications before you pull the plug?
 
Since Big Del never responded and you agree a 20% chance of a severe learning disability warrants death, let me pose some questions to you. In the calculus of whether a life is worth living, how much do the surviving 4 contribute to society, on average, during their lifetimes? Is the cost avoided by killing one baby in 5 offset by the value produced by the other 4 you decided not to kill? If your wife was pregnant, what is the probability of having a child with severe learning disabilities before you would terminate? What is the cutoff for medical cost for birth complications before you pull the plug?

with all due respect Tenacious...what other folks do in cooperation with their physician really is none of your business....or mine. It is their decision...a decision that they need to live with the rest of their life. Why get involved in other folks dilemmas?
 
with all due respect Tenacious...what other folks do in cooperation with their physician really is none of your business....or mine. It is their decision...a decision that they need to live with the rest of their life. Why get involved in other folks dilemmas?
Big Del affirmatively started the conversation with assholey comments and Tunza agreed with him and affirmatively joined the conversation. I am probing the reasoning underpinning their opinions that they injected into this thread. I am not asking others to share the medical decisions made in their lives.
 
Pfizer, as an example, spent about $8 billion on research and development in 2018. “Selling, informational, and administration” costs were $15 billion. Total revenue was $55.5 billion. They returned $12.7 billion to shareholders. The CEO had about $27 million in compensation.

So, your guess is wrong.
What percentage of new drugs on the world market historically come from United States?

that would be an important piece of info.

It would be nice to classify only the new drugs that really help in the fight of serious illness but not sure that can of detail can be found.

I would have no problem making drug advertising illegal. I am sure physicians hate it when their patients think they know what they need based on a TV ad and google.
 
with all due respect Tenacious...what other folks do in cooperation with their physician really is none of your business....or mine. It is their decision...a decision that they need to live with the rest of their life. Why get involved in other folks dilemmas?
As a point of reference, here are his comments:

"That baby is one of the reasons healthcare is so expensive in the USA. Not only will he cost millions of dollars more just to get to 18 years of age, but the parents now have about an 80% chance of getting a divorce. As a society, just because we can keep a micro premie alive, should we? They often have cognitive issues, 20 percent have severe learning disabilities. That not only puts a strain on our health care systems, but also our schools and other infrastructure in place once they become adults."

"Yeah, and there are those that would contend that you are a selfish prick. "It is my right to spend $3M worth of societies resources and have a 1 in 5 chance of having a kid that will never be a productive member of society, will only drain it." This is an ethical dilemma that doctors talk about everyday. The fact that we can save a 1.4lb premie does not mean that we should."
 
What percentage of new drugs on the world market historically come from United States?

that would be an important piece of info.

It would be nice to classify only the new drugs that really help in the fight of serious illness but not sure that can of detail can be found.

I would have no problem making drug advertising illegal. I am sure physicians hate it when their patients think they know what they need based on a TV ad and google.

About 60% of new drugs come from US companies. The next highest country is Switzerland at 13%. All other countries in single digits. There was a WSJ opinion piece a while back about how other countries freeload off US research and development. But, it is complicated since many of the US companies have research and development labs based overseas and manufacture many of their drugs outside the US. I doubt the US companies care about the freeloading because they make a killing on sales in America (see profits above).

Define "serious illness". Good luck with that. Erectile dysfunction, for example, isn't considered a "serious illness" but the effects of erectile dysfunction on relationships, mental health, and so forth are not insignificant.

Drug advertising should be limited to providers. Advertising directly to patients is not beneficial for anyone but the drug companies.
 
About 60% of new drugs come from US companies. The next highest country is Switzerland at 13%. All other countries in single digits. There was a WSJ opinion piece a while back about how other countries freeload off US research and development. But, it is complicated since many of the US companies have research and development labs based overseas and manufacture many of their drugs outside the US. I doubt the US companies care about the freeloading because they make a killing on sales in America (see profits above).

Define "serious illness". Good luck with that. Erectile dysfunction, for example, isn't considered a "serious illness" but the effects of erectile dysfunction on relationships, mental health, and so forth are not insignificant.

Drug advertising should be limited to providers. Advertising directly to patients is not beneficial for anyone but the drug companies.
So it seems plausible to suggest if we hammer drug companies we will see less advancement in treatments.

My point is, nothing is cut and dry and any action will have consequences.
 
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