Medicine in the USA, how much do medicines cost in the USA, how to get to a doctor in America, health insurance – read US news on ForumDaily

Medicine in the USA: expensive and even more expensive

In the US, the state believes that the main thing is the market and competition. This implies that the state must first of all ensure that monopolies, cartel agreements, corruption schemes and other types of unfair competition are not formed, and the self-regulating market will do the rest. This all implies a minimum of government regulations and restrictions in all areas with the exception of critical services, one of which is the healthcare system, writes user Diaver in the North American Peekaboo community.

Further – from the first person.

Medicine in the States is not just expensive, but insanely expensive. Medical bills are the most popular factor in American bankruptcy. I will give an example from my invoices for understanding the order of prices:

A tick has stuck to a child. We went to emergency. We stayed there for about half an hour. The doctor simply removed the tick, specified how long it had been clinging to it, and that was it. The bill for this was 421 bucks.

• My wife felt unwell, we again went to the emergency room, spent about 4 hours there. The bill for this visit is 3500 bucks.
• A colleague with kidney stones went to ER for about 6 hours. The bill was 6500 bucks.
• Childbirth cost 10,000 bucks.
• A visit to the doctor for an on-duty examination of a child costs 150 bucks.
• The cost of the operation can be tens of thousands of dollars.

From a conversation with American colleagues, it becomes clear that the Americans themselves, by and large, do not know where such prices come from. There are quite a few different versions:

• medical mafia;
• a huge number of state regulations;
• non-transparent pricing. The bill for the same service for different people can vary dramatically;
• very expensive insurances for clinics and doctors, which are bought to protect against claims from patients.

Medical insurance

Without health insurance in the States, nothing. If you have some health problems worse than a cold and you don't have insurance, it's cheaper to die.

There are several different types of health insurance in the States. For one type of insurance, you pay out of your pocket every year, for example, 800 bucks, everything above is paid by the insurance company. On the other hand, you pay only the obligatory fixed fee for admission (pay), the rest is paid by the insurance – I have just such an option.

What pay? After visiting the doctor, you pay your small and fixed part of the payment. That's what it is pay.

The size pay for my insurance:

• for a visit to the doctor or in an ambulance (urgent care) help 30 bucks;
• for a visit to the emergency room – 150 bucks;
• childbirth – 250 bucks.

Why this pay needed: in a nutshell – so that patients do not zaalbyvat doctors and insurance companies with fictitious diseases.That is why every visit costs money.

The last major reform of medicine was about half a century ago. Under this reform, the state decided that medical insurance should also be provided free of charge to older Americans. Companies began to provide insurance to employees. The money that companies spend on insurance is subject to tax deductions. For the most part, when an American goes to work, the employer provides him with insurance, part of which is paid by the employee himself. If the employee is a family member, the insurance covers members of his family and children under 21 years of age. The amount that an employee pays for insurance is deducted from the salary and is not taxed. After Obama's medical reform, the state began to issue health insurance to the poor through a special service.

What if there is no insurance and no money? You can also come to the hospital in the same way, and the hospital has no right to refuse help. The hospital itself understands that no one will pay them money, but there is nothing to do – this is one of the factors in the growth of the cost of services. Those who have money pay the costs of clinics from those who do not have money.

Another very important factor is that insurance companies do not work with all clinics and not with all doctors. Everyone they work with is considered online (In network), all others are offline (out of network). If you come to a clinic that is not in the network of your insurance, then things are bad, the insurance, depending on the policy, may refuse to pay at all or pay only part of it. Moreover, even the doctor himself, who works in a clinic that is "online" may be "offline". One of my colleagues got intoemergency room” at the clinic “online”, and the doctor who treated him turned out to be “offline”, and only after long conversations did the insurance agree to pay 1,500 bucks for the services of this doctor.

It is important to note that the law limits the profitability of insurance companies. They can keep no more than 20% of the money. All other money should be spent on insurance payments.

The cost of insurance for a family, in my case – 500 bucks. For one employee about 100 bucks a month. Insurance includes dentistry with a bunch of restrictions and vision (vision).

Vision in the States, this is a separate type of medical service in a separate clinic.

It is important to understand that insurance is provided by the company. The conditions, cost and quality of this very insurance vary greatly from company to company. For companies, good insurance is a kind of competitive advantage to lure employees.

Types of medical care

1. Just a visit to your doctor if you get sick, regular check-ups of your child, vaccinations, and other non-urgent medical services. In this case, you need to call the reception and make an appointment with your doctor. Can be scheduled on the same day, the next day or every other day. Payment pay such a reception in my case 30 bucks.
2. Something happened to you and you need to go to the doctor right tonight, but this is not fatal – this is already urgent care. You come to the clinic during business hours. You wait in line and get an appointment with a doctor who decides what to do with you next. Payment pay such a reception in my case 30 bucks.
3. If you woke up in the middle of the night and feel that the hood still came and you urgently need to see a doctor, then your only option is emergency room.Alternatively, call an ambulance or drive yourself by car or taxi. Calling an ambulance in case it is not covered by insurance can cost 800-1000 bucks, so it's better to get it yourself.

AT emergency room you will immediately be directed to the ward. Soon a nurse will come to you, measure your temperature, pulse, pressure and enter all the necessary information about you and your complaints into the computer.

After the nurse has finished all the preparatory work, the doctor will come and begin the examination. The doctor can immediately send you for tests if they cannot be taken on the spot. You will be taken to the tests in a chair. If surgery is necessary, you will be immediately taken to the operating room. Payment pay such a reception in my case 150 bucks. The bill that the clinic will issue the insurance in case of a more or less serious case is measured in thousands of dollars.

The quality of medicine

In a nutshell. The quality of medicine is at a very, very high level. Let me tell you about the birth process as an example.

Interesting fact: in English there is such a word as “Delivery“, which means the delivery of something. When the postman brought the parcel to you, this is Deliverywhen the courier brought you pizza – this is also Delivery, so, childbirth is also Delivery.

Let's get back to birth. On the appointed day, my wife and I arrived at the hospital at 7 am. We were taken to the delivery room.

The wife was helped to change into a special attire and connected to two sensors for pulse and contractions, after which she lay down on the delivery bed. It is interesting that in the States it is extremely welcome if close relatives are present in the ward during childbirth. There is even a sofa especially for them. Relatives do not need to take off street shoes and clothes.

During the whole process, at least one nurse is next to the woman in labor, at one moment there were two of them at once. The nurses changed every 4 hours. The nurses who were finishing their shift would bring in a new nurse and introduce her.

For those giving birth whose English is not their first language, a certified interpreter must be present during the entire process. The hospital provides an interpreter.

At some point, the wife needed an injection into a vein. The nurse gave the injection, and she made two attempts. According to the regulations, a nurse cannot make more than two attempts; after two unsuccessful attempts, she must call an anesthesiologist. The doctor got it right on the first try.

At one point, a doctor-intern was brought to us. She apologized for a very long time and asked permission to ask a few questions and be present at the actual birth process.

After that, a procession of two or three doctors came to us several times and supervised the whole process. It is important to note that the entire medical staff was very polite and friendly. Everyone was very patient and extremely tactful – I personally was very surprised and pleased.

There was also a kitchen with a refrigerator, which had juices, ice cream, some sandwiches and other snacks that you could take.

In general, you can talk about the process of childbirth for quite a long time, but I was very delighted with everything: from the staff, from the equipment of the clinic, from a clear order in all procedures. The impressions were especially vivid in contrast to the process of giving birth to the first child. The doctor, as I later found out, behaved like a complete asshole, and I paid him very good money for those times. The good ones are his monthly salary.

The whole birth procedure cost about 10,000 bucks, of which I paid 250 and which the company later returned to me in the form of a bonus, for which I am very grateful to my office!

I hope that such a small example made it clear that the level of medicine is at a very high level.

Pharmacies

You can’t just go to the pharmacy and buy any medicine just like that. Just like that, you can buy vitamins, antipyretics and something similar. In all other cases, you need to get a prescription from a doctor. The doctor sends the prescription to your pharmacy. After all the medicines are prepared, the pharmacy employee will call you and inform you that you can pick up the order.

The drugs themselves are also covered by the insurance, you only have to pay a certain percentage of their cost. All financial settlements with your insurance pharmacy are carried out by themselves without your participation.

An interesting fact: medicines to prevent pregnancy are fully covered by insurance, that is, 100%. The insurance company decided that it was much cheaper to pay for contraceptives than to pay 10,000 bucks for childbirth later.

Important note: The information in this post has been compiled from various sources, including the author's own experience, and may contain inaccuracies or errors.

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