I am not from the US. Had my close relative fight with cancer. If not for the government which sponsored it almost fully, excluding a couple of procedures like PET, it would cost our family a lot. Just for the scale: pial for one infusion of one out of three drugs would cost us $8k and my relative would’ve needed 16 infusions.
Holy crap, all these answers and hardly anything about how health insurance is supposed to work.
Basically, most people have health insurance. With the Affordable Care Act (aka Obamacare) from years ago, it’s basically required but getting care is simpler (you can’t be denied a plan for a preexisting condition, for example. But it’s hella expensive. It’s also typically tied to your employer as part of your compensation package like retirement contributions, which means if you change employers there’s a good chance you need to change insurance and even doctors.
ANYWAY, say you have procedures done. Insurance companies typically have contracted amounts for stuff with each provider (a “discount” from insane prices nobody actually pays). You typically pay the first however many dollars, depending on what you’re having done and how your plan works. Eventually, you’ll reach a dollar amount that’s your maximum for the year, and from there insurance generally covers everything they normally would
Some people also have Medicare (ages 65+) and/or Medicaid (based on income or disability). Some people have private insurance on top of it. My daughter was born extremely early and stayed in the hospital for months. Her very low birth weight was a qualifying disability for Medicaid, and she was on my work health insurance. Claims would go through work insurance first, and any remaining costs (deductible) would be passed to Medicaid. If there was anything left, I’d be responsible for that. But I don’t think that ever happened
Obviously, coverage is different for different people - different employers have different plans that cover different things differently. But in theory, that’s how it should work.
You start a GoFundMe then die
This is, increasingly, the answer.
They made a really good documentary about this a few years ago:
You have money or insurance (if they dont deny coverage) or you die.
are you asking how we treat, or what do we pay?
many people with cancer in the u.s. go the cheapest routes for treatment because some are incredibly expensive. hospitals are only required to ‘stabilize’. they are not mandated to cure. poorer people have worse outcomes as they cant afford the best treatments.
are you asking how we treat, or what do we pay?
Both actually.
cheapest…they are not mandated to cure
So even the stabilization requires paying the bill? Isn’t it like an emergency medicine where doing nothing just kills?
yes, there is no free healthcare.
those with the lowest incomes qualify for government assistance in the form of medicare/medicaid but this is fairly minimal and specifically excludes most novel treatments. our republicans/conservatives continually find ways to reduce this funding. they are truly awful human beings despite being the ‘pro life’, ‘pro god’ block of our electorate.
the united states sucks donkey balls for poor people considering its wealthy status otherwise. all that money is at the top, and its getting worse.
We are responsible for paying for emergency medicine
But like, after one’s stabilized?
Hospitals are required to provide emergency treatment - what we call ED or ER visits - regardless of ability to pay. Patients are expected to pay for that treatment. It’s just that the hospital isn’t supposed to deny treatment based on whether they think patients will or won’t pay the bill. This is getting-stabilized treatment.
This is an important point in arguing for universal healthcare: if people can’t afford treatment, they’re more likely to go to the ED where they won’t be turned away. ED visits tend to cost more than non-emergency, so that drives costs up.
That’s monsterous.
Yes.
Found this post as well. ED is not always an option
In financial terms, for most people the government doesn’t help you at all[1]. Either your private health insurance pays some of the costs, or else you pay completely out of pocket. Even if you do have health insurance, it’s still going to cost you several thousand dollars per year until it’s resolved. It’s quite common for cancer to cause people to go bankrupt even with good health insurance.
If you’re 1) old or 2) through means testing are found to be both poor and physically unable to work, then you get government-funded a health insurance plan. You still might go bankrupt though, just as with private health insurance. ↩︎
And after I go bankrupt, my children go broke, could I receive the governmental treatment for remission?
Are you asking about the specific course of treatment, which will verify by type and stage, or how people pay?
As for paying, the only national programs are Medicare (restricted by age) and Medicaid (restricted by income). The US veterans administration is a separate govt program for military veterans and I believe their families, too. Everyone else either has some level of insurance provided by their employer (which will still generally be terrible), or nothing at all.
The charts here are helpful https://pmc.ncbi.nlm.nih.gov/articles/PMC6778988/
It looks like if a person is above the poverty line and is under 65 they will have to pay like 20% of the medical bill which could be insane, given they have an insurance. Otherwise most first line treatments are covered by Medicare and Medicaid Plan B.
So if a person earns, like not insane $3k/mo, they will most certainly be billed with enormous bills and be refused to be treated again in case of relapse, just because they haven’t paid the previous bill?
So there is also an out of pocket maximum which is the most you’ll pay in a calendar year no matter how much your expenses are which vary by insurance plans but in my experience have generally been between 5-15k with 15k being for much cheaper insurance and 5k being for better insurance so if you have 1m in medical expenses and copay would be 200k it would instead be just that max out of pocket of approximately 10k, which while not great is much more manageable. The unfortunate thing is that is tied to the year so if you start treatment in November and finish treatment in March that 10k per calendar year turns into 20k since it was over the course of 2 years
max out of pocket
That’s what I’ve been missing all this time.
Bottom line is:
If you have income above the poverty line, say $2k/mo, don’t pay the insurance fee for some reason (the income is from something shady like onlyfans or etsy), you don’t have a disability, and you’re younger than 65 - only then you can get million dollars bill.
Otherwise, cancer treatment could cost you up to $15-30k and sometimes even be free.
Generally speaking yes, some caveats where people still end up with more debt than they can handle is if you have a family insurance plan your max out of pocket usually doubles, so you can be looking at 2x the amounts I quoted.
The other big one for a lot of health insurance in the United States the employer pays a percentage and the employee pays a percentage for it so generally speaking shittier jobs pay a lower percentage and have worse plans so a person making 30k/yr might have to pay $300/mo for kind of shitty health insurance and if they have the mindset of “I never get sick” that’s an easy expense to cut so they can end up with the uncovered medical expenses
Then there is also if a person leaves a job and before they get a new job they are without insurance and you can pay the entire premiums yourself but those can easily be hundreds of dollars that if you don’t have an income can be rough
Also companies don’t need to contribute to insurance unless you are full time so it’s a common practice that companies like Walmart will intentionally keep people part time so they don’t have to pay benefits and a person ends up working two jobs so they still make too much for Medicaid, don’t get insurance through either job, and are usually still trying to pinch Pennies to save money so shelling out the several hundred dollars a month doesn’t seem worth it
Personally what I find to be the ironic scam of all of this is people in the U.S. generally pay for insurance directly out of their paycheck and so when they talk about their paycheck being so much smaller than their gross salary they always blame “taxes” when in reality a sizable percentage of their salary is going to health insurances, but they don’t want nationalized healthcare because it would raise their taxes more than it is. When in reality US citizens pay more money between health insurance, Medicaid, Medicare, copays, etc then the cost of health care in countries with “free” healthcare by 50-100% and have lifespans that are significantly shorter
Yeah, thanks for the explanation. I think I have a better understanding of the US healthcare system.
As for the people, they are just parroting the media, nothing new here.
In addition, medical costs in the US are higher than many places, because the insurance companies don’t have to bargain with the whole nation at once. Even Medicare and Medicaid have historically been prevented by law from using their full bargaining power in some cases.
I don’t actually know what happens to medical coverage if you have medical debt. It will eventually go to collections and can be used to garnish your wages, I believe.
That’s really sad
If your country has a better system, it is because the unions and the left have fought for it. Don’t let the Macrons of the world do to you what Reagan did to us.
This cannot be screamed loud or often enough!
Like most other countries, expect that a lot of people only treat what they can afford. A lot of Go Fund Me sites have been created due to expensive medical treatments.
Ok, I get the Black mirror reference, but I wanted serious answers
they are being serious, though. a lot of people in the US use fundraising platforms like GFM in order to afford medical treatments. not just cancer, but other important surgeries, medical devices, service animals, etc. even if they have health insurance. insurance companies can semi-arbitrarily decide if the issue is “severe” enough to warrant full coverage (or coverage period).
TIL that go fund me is actually charity and not a onlyfans predecessor
Yeah, it’s easy to think people are joking about using Go Fund Me for medical treatments, but it’s real. More than that, you’ll see news stories here about people donating their money so a kid can get some treatment, or their time off so that a parent can take a kid to their treatment, and they’re treated like “feel good” stories about communities banding together rather than the dystopian hellscape that they really are. The US is capitalism run amok, and the populations of other countries really should take notice before their wealthy classes succeed in making the same political decisions that got us here. It’s already happening in the EU.
This was a serious answer.
Sorry, googled it. The actual fuck
