I would argue we know our maximum out of pocket. Mine is $3,500 so that just goes in my HSA every year. After you hit the max out of pocket bills are $0.00.
You better visit Korea for medical care. Even without insurance, non Koreans are charged no more than 50 bucks for most simple procedures. One of my acquaintances had serious surgery on his intestines last year. He told me that he called an ambulance, were in an emergency room, had a serious surgery and hospitalized over night. He got billed only 800 U.S. dollars. Lol. He is a Korean American. One reason I never consider immigrating to U.S. is because of medical bills. It is brutal. I notice more Americans are visiting their friends and families in Korea and take opportunities seeing doctors and getting treated here because it is much cheaper. Me? If I see a doctor with insurance, it will cost 5 or 6 dollars. LOl.
My nephew died because he didn't want to go get his leg checked out. He was saving for a down payment for a house and didn't want a big bill. It was a blood clot. He died putting his boot on to go to work. He was 26
I had a student coworker at the Library in college who died when she had stomach pains. Didn’t get it checked because she didn’t have insurance, and died overnight. That was at a time where you fell off parental insurance at a young age, I think 21.
It’s definitely a scam! I had a miscarriage about 2 years ago and went to emergency room for it. They did an ultrasound and that’s just it. Billed me $3000 with insurance!!! 1 year later I gave birth to my baby, got billed for $3000 for uncomplicated labor and delivery with insurance. So that ONE ultrasound to check the miscarriage is the same cost of 2 days in the hospital?! It’s crazy!
Did you call your mother, aunt or grandmother first? They would've helped you decide if you needed medical attention. To them, miscarriage was part of their child-bearing years. A nurse midwife is also a person to contact.
Right. Because you're not just paying for your own medical coverage, you're paying for everyone's medical coverage thanks to the ACA. Hope everyone who voted for the mess we have today realizes this.
@@TeddyLeppard Actually the ACA is the best thing that could've happened. The system is set up so that people that make a lot of money pay for people who don't.
Even 15 years ago my primary care doc said to me "the health insurance companies don't really care about your health." He was not wrong and I always keep that in mind.
I'm South Korean. My dentist quoted me $1k to get 1 wisdom tooth removed, *with* insurance. I went to South Korea to get my wisdom teeth removed. They removed 3 and charged me $50, without insurance. I would rather live with an injury in the United States rather than get medical care.
@@disarchitected The US subsidizes the South Korean military. We also operate US military bases and station US troops in S Korea. So their tax dollars are available for healthcare.
I got an emergency healthcare from when I was travelling there. The quality of care was amazingly high. I felt like I was in a private clinic in Beverly Hills. The medical technique used was the state of art. When I got the bill, I was really blown away. It was so low, I just paid out of pocket rather than going thru my US based insurance. The whole experience literally blew my mind.
Shelby - you are 100% right. As a physician in the U.S. for the last 17 years, everything you described is happening and I see it on a regular basis. But it’s even worse than you know. More physician practices are being bought up by healthcare systems, contract management groups, or corporations owned by private equity. If you speak out about it, you are sued, fired, blackballed, given a disciplinary action in your employment file, reported as “disruptive” to regulatory boards, or a combination of these. I’m not talking about disinformation that has become rampant since COVID but rather the profiteering by rich business people and politicians on the back of patients, doctors, and nurses. I’ve even had these same insurance issues (as a physician who knows the system!) that you have, including a surgery from last year. There’s a great explanation of private equity in healthcare by More Perfect Union. There’s also a great book about the history of US healthcare called The Social Transformation of Healthcare. The author wrote it in 1983 with predictions. He did an updated 2nd edition with an epilogue. Almost all of his predictions from 1983 came true. Happy to discuss this more and in exquisite detail.
Much of that is why I’ll never work as an RN in the US again. The rest is because when i broke my back i couldn’t get care. No one took me serious. 10 mos later got sent for STAT MRI r/o cord compression. Talk about system failure. 😞
I had heart attack and stayed over night just one night with cath procedure for just one stent...total cost 260k !!! Ambulance alone is 3000 for one trip under 5 minutes!! Shelby please go into politics and fix this! I will vote for you!!
When retired couples have to pay on average $300K on healthcare expenses throughout their retirement, the entire system needs a major overhaul. This commentary series is my favorite thing to watch so thanks Shelby
My financial planning tool estimates we will spend $300K EACH over our retirements. So $600K for the two of us. It is costly for sure. The good news is our retirement plan is still projected to succeed for 99% of future scenarios, but it does divert money away from fun things. I came into retirement with my financial eyes open. What I was unprepared for was the amount of time I'd need to spend on the phone resolving one issue or another. The complexity of the system is a huge time sink.
Well, that's what happens when you allow a revolving door between corporations and government. Corporations come up with the schemes and government does the gatekeeping.
3 month ago I was in Bangkok, Thailand and got sick. I asked the hotel staff on if there is a hospital around. They managed everything for me. A cab picked me up from the hotel, cost $1.50. Went in front of the hospital which looked more like a high end resort. A person opened the car door and walked me into the hospital to the front desk where I was greeted and offered a bottle of water. I gave them my passport and they filled out everything. After sitting down for 5 minutes, they gave me a paper and sent me to the 7th floor to see the specialist. Before that a nurse did a full check of things. The doctor was good in English and I explained my situation. He checked me out and prescribed me the medicine. The hospital had a pharmacy on every floor. I went there, gave the person my paperwork and 5 minutes later I had the medication. Overall, it took about 60 minutes from start to finish and cost me $35.00.
This is how private medical care works in most countries around the world. US is the only developed country without universal healthcare or mandatory universal coverage.
My parents are in their 70s & rarely go to the doctor because they just can’t afford it. My mom, who’s never been in great health, said she purposely avoids going because, if they find something that requires treatment, they can’t afford it anyway. This s**t makes me so angry, and so sad.
They should be on Medicare. If they have a supplemental policy (plan g) to go with that, the only cost should be a $240 Part B deductible. Of course, there's a $174 monthly premium for Medicare Part B taken out of their Social Security check and another $125 for the part G supplemental policy for a total of around $300 a month.
my company contributes 1.75x of whatever I do... but it's also a Dutch company. but I work in America so there are definitely better options out there. but totally agree it should be standard
Yep, so essentially they keep your salaries low partly because your money is going to pay for that health insurance that the employer supposedly pays for you
Back in the 90s a lot of companies paid for your health insurance completely and nothing came out of your paycheck. In 2002 I got a job where they wanted $100 out of each paycheck for health insurance and I was so confused and thought it was a scam.
@@SteveWiIIDolt Yep, exactly, when I started working companies paid for your insurance completely. Now it's very rare, haven't seen a company yet that I have worked for that doesn't do it for free anymore. On average I find about I pay about $50 a week to pay toward Dental, Health and Vision, with Health being like 95% of what you pay for.
I’m in Canada and had a colon cancer diagnosis 5 years ago at 28 years old. I had many procedures, a surgery(within 2 weeks), 6 nights in the hospital, bloodwork every 3 months and yearly CT scans, ultrasounds and I didn’t pay a dime for any of that, never even saw a bill! I have extra coverage through my employer and for prescription meds I only pay a $3 dispensing fee. Not everyone has a positive experience, I work in healthcare and I see everyday how the system in Canada def needs a thorough overhaul. Waits for non urgent/elective ortho surgeries is outrageous for one. Many people fall through the cracks but I would never trade our current system with its flaws and all for the American Style healthcare system. I am extremely thankful to live where there is universal healthcare.
Years ago, while travelling to the US, I had really severe tonsillitis and I had to go to see a doctor. He told me that if I was a US citizen, he would’ve sent me straight to the emergency room, but because it would be so expensive, he instead put me on a high dose of antibiotics so that I could fly home. All up my care in the US cost me AU$800. Upon going home, I went to emergency in an Australian hospital and saw a doctor, bought another course of antibiotics and all kinds of painkillers and it cost me a grand total of $21.
Again, it's pointless to compare countries. There are too many different factors at work. In countries with socialized medicine, people are STILL paying a lot of money for "free" services, but it has been folded into the much higher taxes they pay their government.
@TeddyLeppard At the same time, people see their taxes doing actual work. Meanwhile, US taxpayers are paying for thousand dollar toilets for the air force
It actually cost you a lot more than $21. You were taxed at a much higher rate than we are in the USA and that paid for the health care system. You just paid it over your lifetime rather than all at once.
I work in a pharmacy and it blows my mind how a drs only prescribe a pt something BECAUSE they NEED it and the ins will reject it, requiring a prior authorization from the dr telling them that they NEED it 😩
American in Mexico: I had a freak'n tumor in my head and it took over 6 months to be seen in the USA!!! I had insurance and it was over $800 just for the MRI. I haven't had to go through anything serious in Mexico, but a normal doctor visit is less than $3 and you just show up (walk-in clinics)..without insurance! It's less than $40 for a filling...no insurance! It was around $75 for the OBGYN for pap smear, ultrasound, HIV test (they really give you a thorough exam)....no insurance!
Oh, I forgot to mention...you know the price before you go!!!! You can literally look up how much it is for lab work or an X-ray...no surprise bill 5 months later!!
Our “urgent care” facility here in AZ now won’t take walk-ins. You have to make an appointment they have 1-3 days out. It’s a mess. We need corporations and insurance out of healthcare.
A relative of mine is an executive at Cedars Sinai in Los Angeles. In a casual conversation, she said that their hospital is "non-profit" in name only. The parking garage for execs and top docs is full of very expensive cars. She had to ask one colleague why he was parking his McLaren sports car so that it was taking up two spots. And while the MD's are obviously well-educated in rigorous college and grad school programs, some of the top execs went to mediocre state universities with majors like "healthcare administration" which don't seem rigorous or competitive at all.
as an endocrinologist the cost of insulin riles me up so much!! we let insurance companies make massive profits off this medication while I have many patients who just cannot afford to pay for it, and then later get admitted to the hospital because their diabetes is out of control. thus increasing their costs (and taxpayer costs) even further! it makes absolutely no sense and just feels so unfair. edit - whoops, accidentally replied to a comment instead of the video! but to actually reply, a great minority of doctors are making enough money to get a fancy sports car. plastic surgery, neurosurgeons, yes, but most of us have an insane amount of debt and thus live middle class or upper middle class lifestyles. thus why there is such a shortage of doctors - why do insane training for 10yrs of your life and make less than many of classmates who got job straight after college
@@DrMichellePonderAmen!! It’s not all insurance companies dictating this though. I work in contract negotiation at a health insurance company. Hospitals (especially specialty hospitals like cancer facilities) expect almost a 2000% pricing increase for CHEMO and RADIATION. That is DISGUSTING. And the worst part of this is that the patient cannot receive the necessary care until the health insurance company accepts this horrendously gross charge from a “hospital”.
you and they dont know what non profit means lmao and they work there lmfao. of course they all get paid handsomely thats where the money goes and at the end there is no profit for the hospital they spend it all on themselves or equipment dummy.
Doctor here- I have more detailed vids on my channel about this but you're absolutely right that healthcare in america is a ripoff. To weigh in on the 45 minute appointment charge on the billing- you are right that they did not spend 45 minutes with you but they likely were not billing on time but on the 'moderate MDM' (mdm = medical decision making) portion. A lot of billing codes providers use act like this- they can be used to bill via time spent or complexity of care. You cannot tell based on the bill as it is but you can tell from the note they had to write- if they do not have a portal for you to see your note, thats technically illegal now but some hospitals havent caught up- but you can ask for note to see what they wrote. If they wrote something along the lines of 'I spent >45 minutes with greater than half the time spent face to face with the patient' then they were billing based on time. And based on how much time you said they spent, they did not meet that. More likely however, again they billed you based on complexity of MDM because we are not good at keeping track of how much time we're in the room with a patient. In your case given you are young and you went for what should have essentially been an urgent care visit, they should not have charged you for moderate MDM. If you get a copy of the note and there is nothing that mentions time spent (if it does, its your word vs theirs and admin will fight you on it) and the assessment and plan typically at the end of the note simply has something like #sinusitis and what they did (not a lot) with no other problems then at best they should have billed Low complexity MDM (99203) or even more appropriate is straightforward complexity (99202). If that is the case you absolutely should argue for your visit to be re-coded. Most doctors, PAs and NPs get little to no training on medical billing and have no idea what the specifics are for billing codes they use a lot. Most likely the provider you saw only ever bills moderate or high mdm for new patients and that works for 90%+ of people they see on a daily basis and for the ones it doesn't, they don't fight it. With regards to the recording aspect, you definitely would need to legally ask before doing so- I personally would have no problem with it though I know many colleagues who would be uncomfortable with it- that being said you're within your right to do so, and until healthcare in america is better (not holding my breath, I'd die) thats probably the only way you will have proof to argue with more than just your word vs theirs.
Last time I went to Urgent Care, they charged me $652, for them to tell me to go to the emergency room. I was only there for a total of 15 minutes, which 10 of those minutes was sitting in the waiting room. While in the hospital recently, it cost me $2000 a day for my room and I had to pay New York state $250 dollars surcharge for staying in the room.
I have lived for most of my life in the US but during covid, I went to Poland and got stuck there for 4 months. While I was there, I got injured. Went to a private specialist( $25) within a week and got an MRI, privately- as in I had to pay out of pocket, and it cost $100. Once I came back to the US my injury came back after 6 months and it took 2 weeks to see a specialist. The doctor saw me for less than 5 minutes. Also in the US I had a friend coughing up blood for a week. She went to the ER. They told her they couldn't do anything and to see a specialist. They even gave her a referral. It took 6 weeks to get an appointment. We live in an area with over 100 hospitals.
I lived in that country for years. Nothing is free, and you need to wait years in line to get to specialist. My friend in PL was shocked that I got to orthopedic within 3 days in US with child collar bone when she had to wait 6 months with her broken leg child. So a lot people have to go pay private and it's expensive for them. Everything is way more expensive for PL people that to you. And I hope you didn't experience standard hospital care, that is way way below US standard. I experienced both so I know what I'm talking about
This is why i love traveling abroad! I do all the visits..vision, dental etc ...blood work ...it is still cheaper to fly, stay a few day, and see drs all together than it is here in usa ..its crazy
Shelby, thank you for making this video. I work in contract negotiation and coding at a health insurance company. Many people do not realize how much medical facilities (especially specialities like cancer hospitals) will jack up prices and require insurance companies pay up or else the patient will not receive care. A smaller group funded health insurance company canNOT afford to pay a 2000% mark up on $300,000 for cancer care. Imagine the stress on all of those involved due to the greed of these facilities. Most importantly, that poor patient who is essentially being held hostage in all of this. Also, I’d really be shocked at a non-profit not performing care for ectopic pregnancy or a d&c for a miscarriage :( so so so different from an abortion in many ways, despite coding.
Getting healthcare in the US is basically buying a subscription to get a coupon (insurance) that you don't know how good or bad the value of that coupon is. 😖
The USA is actually the only developed country that has failed to implement Universal Health Coverage. UHC is basically a system that allows people to get health services they need in a timely manner and without financial hardship. The first UHC systems originated in Europe and this is why our healthcare is so much cheaper even now in comparison to USA. While it is based on values of social equity, it is not »socialism« (which sadly lots of Americans still think it is). Due to the lobbying efforts of private industry (mainly private insurance companies and pharma/med device companies), the US has not been able to push through a comprehensive UHC system politically. Medicare, Medicaid, and VA coverage are some examples of trying to establish UHC but they are still very much limited in scope and also (!) they each operate on a different payer system which makes them even more difficult to align. In most European countries, essential healthcare is covered through tax system - and it doesn't matter if you are fully employed or doing freelance gigs, everyone who does any kind of work pays taxes on usually a monthly basis and thus has access to healthcare system. The countries usually also regulate insurance, medication and medical devices costs so the private industry is not able to inflate them like in the USA. And while healthcare in Europe is not perfect (we are also facing lack of health workforce, long waiting times, etc.), we don't experience »going broke after visiting a hospital« so people regularly go for check-ups and other procedures, including preventive services. This helps keep the population healthier and is also one of the reason why US is stuck in this weird loop leading to bad health outcomes of the population.
I’ve had some loved ones get screwed over and receive horrible medical treatment through the VA. Some have received great care for smaller concerns. I personally do not trust the VA, and this has caused me to lose trust in the idea of a UHC model in the US.
@@ahhitskatie9094 Yep, American demographics and open borders do not allow for UHC, and seen with recruiting crisis, they don't even allow for a military.
@@churblefurblesthose are not the reasons for not having universal healthcare. Europe has open borders, but still provides care for their population and visitors. I had to see a doctor in France - paid 20 euros because I was a tourist, otherwise their system would’ve fully covered the cost. I don’t think Americans even understand how it is possible to get medical care for that cheap or actually free, covered by taxes.
Thank you for covering this!! Over the past few years, I was the sole caregiver for a terminally ill family member, who ultimately passed, and we spent $100K+ on just one year's worth of medical care, even though they had 'excellent' insurance by US standards... Had they lived longer, it would have bankrupted them altogether (which is sadly the case for SO many Americans). If you're keen to do another deep-dive video, I think it would be really interesting to take a look at the cost of rehabs and nursing homes (and the enormous upfront costs of long-term care insurance). I think the country's in for rude awakening as the Boomers age and we continue to have a shortage of medical workers...
Greedy Parasitic private equity has bought nursing homes, hospitals, dentists, vetrinary hospitals(we treat our pets like family) air ambulances($30,000- $600,000 AFTER INSURANCE PAYS) They buy up anything that is a human need. Healthcare is an INELASTIC GOOD, YOU WILL BANKRUPT YOURSELF AND YOUR FAMILY TO STAY ALIVE. AND THE ENTIRE HEALTHCARE SYSTEM KNOWS IT.
Hi Shelby, Justin from Canada here. Our healthcare system is falling apart.... the government (provincial and federal) are letting it happen - heading towards privatization (for profit) like the US. As a healthcare provider myself, it is sad, and as a tax paying citizen it is beyond frustrating, and scary to think about what our healthcare will be like when we get older and need it the most.
don't think so. Canada and the UK have fatal ER wait times where people are dying in waiting rooms waiting for urgent medical treatment. The French and Australian health systems are the best where they combine Public and Private healthcare. Then again Americans subsidize the world's health care as most of the world's medical innovation comes from the U.S. and China is at a distant second and by distant I mean by a galaxy away.
Being a 10 year resident of Canada, I know that if you are SICK and need a doctor, you are seen. I needed a referral to a specialist and was seen in less than 2 weeks. My primary care doc will do phone appointments and you can book one of these within a few days. We also have walk in urgent care. Having lived in the US most of my life, I am fully in support of Canada’s health care system. I have been well taken care of here. ❤ BUT, elective surgery can take months. Canada prioritizes people that are sick, injured and need treatment.
I'm Canadian and it's funny to me because we basically have the opposite problem. I know TONS of people who have flown/driven south to the states to seek care because the wait times are just too long in Canada, especially when you need life saving care. While ours is "free," for the most part (due to very high taxes), a lot of us can't even access it and those who have the privilege of having money will access it in America. Wouldn't it be nice if it was both affordable and available to us both!?
agree!! a girl in my town (i'm in NL) just posted a picture of a letter from our local hospital with an appointment for an MRI. her doctor sent the request in september 2023 and her appointment is for september 2026. people are literally going to die before they can get diagnosed with anything at this rate. i'm lucky to have a family doctor (i think more than half of the province doesn't?) but mine usually takes anywhere from 1-3 weeks to see. so frustrating
I am very surprised. I live in Quebec and I thought we had the longest wait times in Canada, but now that I read you, I will think again... This is so terrible. @@lilkrissyy
This is such a good conversation. Something to add is when we talk about America being so unhealthy while simultaneously talking about our expensive healthcare system, we have to connect the dots here. that if you are unable to access affordable healthcare for your yearly screenings, preventative care, and ongoing treatment of certain conditions (like affording your prescription meds to manage a poor lab value to prevent it from getting worse). The social determinants of health are so often overlooked, then people are blamed and shamed for their health conditions that are lifestyle influenced, but if you don’t have access to affordable/accessible care, that plays a much bigger role.
@shelbychurch Patient: "I need stitches." UK health system: "Your appointment is in 43 months." US health system: "Your bill from 18 different agencies will be $77,000." Canadian health system: "Have you considered dying?"
My husband broke his leg in a ski accident and the insurance company said the total cost was $150k and we only had to pay 7k. Yay. lol this is a scam. I even drove him from the ski hill because we didn’t want to call an ambulance since they cost so much. So sad we all have to think this way 😢
Shelby this is one of the best conversations to be had. Healthcare in America. Why is it so costly and Why shouldn’t everyone person know the cost of services up front? Nicely done Shelby.
There was some guy who worked in the US healthcare system who told me I was clueless when I remarked what a mess it was. He thought it was the best system in the world because the ultra rich fly over from other countries to the top private specialists and that there was no financial concern because if you almost die and end up in the emergency room, they have to treat you (never mind the fact that you have to go into debt to pay for it). These people are insane.
I heard a Dr. say that 95% of patient visits are for things the patients could deal with at home themselves. I'm 59 and take good care of myself. I've never had HC because I can't afford it even with employer contributions. I'm so glad I was smart enough to take care of myself and not fall for their scamming BS. I was a caregiver to a sick parent and the way her GP scammed her was atrocious. A total con artist. But she insisted keeping him. People need to open their eyes and see how bad of a scam it all is. Especially GP and emergency room prices.
Oh I work in pediatrics and did a stay in the ER and let me tell you...the amount of "oh my kid has a fever" patients that come in...yes they look like they're breathing a little fast but that's a sign of fever...kicker is the parents never seem to give them meds, their excuse "I wanted you to see the fever" we'll just give them meds and send them on their way.
Ozempic in Poland - 97 dollars, Ozempic in the US - 980 dollars. EXACTLY the same thing! How is this even legal? It is much cheaper to fly to other countries for medical care. Why isn’t medical tourism a huge industry yet?
@@justtennischannel2 how much is Ozempic price in Slovakia without insurance? Travel health insurance is not always good. I had a bad experience in the past
I worked for Cigna years ago, it was the worst job I've ever had. Insurance companies are hardcore, they are the judge, jury and Executioner. Good luck trying to appeal anything, they are all about profits. Some people don't understand that most businesses are self insured, which means it's in your Employers interest to get claims denied.
I remember needing to get my wisdom teeth removed by a surgeon and my insurance didn't want to pay for anesthesia even though is literally necessary to do the procedure. I had to argue with the people on the phone. Just ridiculous...they ended up covering it at the end of the day. Also I cant believe the head of these hospital systems are making so much money...20mil a year is crazy!
i had a tooth pulled without anesthesia before. it almost sent me into a seizure and caused my death. that big of a shock directly to a cluster of nerves in your head can easily kill you.
Singaporean here. I have not experienced the actual US healthcare when I was there for holiday, and the "closest" one I encountered was in a CVS pharmacy in Vegas. So my mum was sick and they prescribed her some really strong painkillers (can't remember the name, but in short - the painkillers were useless lol, the paracetamol I brought from Singapore worked so much better), and if I am not wrong, we paid over $20 for that tiny ass container, and we were so shocked at the cost. Years later, I had a conversation with an American tourist at my workplace (I used to work in luxury fashion before my current job) and she summarised the American healthcare system with this sentence "The healthcare system in America is literally commercialise for profits, and only the rich have access to such treatments." She even told me she would rather fly to Singapore for medical treatments, as our healthcare system is "more affordable" for them. I now work in a public hospital, and I notice a number of foreigners seeking medical treatment in our public hospital for various treatments to even expectant mums delivering their child here, even though they pay more than a local.
@@churblefurbles Not always the case. There are still rare cases of people accumulating hospital debts, despite all the financial aids available for those in need
I went to an urgent care about 4 years ago. I already knew what was wrong, so let them know.... I got a shot and paid 200 for it. Took less than 30min and spent the majority of the time waiting around. A few months later I received a bill for 1300, I managed to get it tossed out after calling the billing number and telling them I won't pay for it since I asked upfront if the 200 was the entire bill. The entire think felt like a scam when I was on the phone.
I can’t afford insurance in NYC and when I had pneumonia, I ended up in the ER for a steroid and was billed $3k. Our whole system is a scam. Great video Shelby!
Correction around 13:30, I just graduated with a bachelors degree in healthcare administration. A not for profit hospital still needs to profit money otherwise it can’t run. Only real big difference between FP and NFP is tax exemptions. Both FP and NFP need to profit money in order to service patients.
The system is terrible, and don't get me started on wanting to escape - because that's when they get you with the citizen based taxation so you are literally trapped. Being an American is a curse right now, which is a shame because if certain things were tweaked like healthcare and food that isn't filled with chemicals/pesticides, mandated PTO, sick time, paid parental leave and an actual pension for when we are old, and more - it would be a decent place to live. Currently as it stands - this country is a hot mess.
Actually IRS gives you a foreign income exception or something like that. They refund around 140k of your annual federal income tax and this cap gets higher every year. So unless you are getting paid way more, you are good to live abroad. It is a good idea actually, just healthcare and good fresh food are good enough reasons to live in Europe.
The graph at 1:29 says it all. America is the only developed country without socialized healthcare. Congress is ruled by lobbyists and the private-healthcare lobby is a BIG one.
Hi Shelby, This took place over 10 years ago . My first job right out of college was 40 hours but no medical insurance. Then I got a cold which gave me a severe sore throat, I went to a small no name clinic and they gave me a test for penicillin bc I didn’t know if I was allergic. When I tested negative, I got a shot of penicillin and my throat cleared up in 30 minutes but I felt very sleepy. Love that clinic. The wait was 5 minutes and I saw a doctor. I wish there was more of this kind of clinic. I was going to pay whatever and it came out to 20 dollars.
I ended up going to the hospital a week after a car accident I was in. It was a hit and run and my neck and back hurts really bad. I don’t have health insurance. I went to the hospital with the intention of getting a definitive answer as to whether it was just whiplash that will go away, or if it’s something that may be much more serious…. There was absolutely no diagnosis that took place. I didn’t even change out of my personal clothes into a gown. Doc gave me one Lidacane patch, one ibuprofen…. I ended up getting a bill for $1400!!!!! I still am in loads of pain and do not know if I have a broken back or slipped disk or lifelong spine damage… $1400 for one ibuprofen pill and one pain patch🤬🤬🤬
As someone deeply entrenched in the health insurance industry, I can't help but acknowledge the exorbitant costs, absence of pricing regulations, and opacity in the system. However, the issues extend far beyond just the point-of-service aspect. Much of the accessibility promised by the Affordable Care Act has been distorted by the maneuvers of insurance giants and hospital conglomerates. It's akin to what we've witnessed in other sectors-universities, lenders, and Congress wrecking the economy with college debt. It's a harsh reality that calls into question the integrity of the healthcare system in America, the financial institutions we trust and Congress selling the country to profiteers.
a hospital tried to charge me $80 for asking a simple question about my health while i was at a simple physical checkup covered by insurance. i still have not paid and dont plan to. scummy shit, just insane what these places pull on us
yeah depending on what is discussed during the visit they can and will bill you more, even if it’s just a simple question. learned this in PA school and it’s the tip of the iceberg when it comes to healthcare and billing
@@Archchill learned the hard way, if they weren't scummy POS they would have told me I'd be charged for it though and then I would've told them forget it I'm feeling amazing actually. I didn't get anything extra and didn't take more of their time up than the physical I was there for. Regardless, it won't be paid.
@@TheSpicydiva i agree with you guys that it’s terrible, but reporting them to the state medical board won’t accomplish anything as it’s fair game under the current rules. As for telling the patient that asking certain questions can raise the bill, well that just opens a whole can of worms where the patient might have questions about that thus taking up more of the providers time to even as far as the patient withholding information due to fear of being billed. the entire system needs and overhaul, from scratch, but that won’t happen because certain people are making too much money. look up how much the hospital administrators, directors, and president are making and then ask yourself what exactly are the individuals contributing to the hospital? Look up how much the CEOs of insurance companies like united healthcare are making? how much the pharmaceutical execs are making. look at how much is being spent on lobbying by these people/industry. then it all makes sense, and you’ll see why nothing will change. TLDR: its really not your providers fault
I really liked this video. I worked for Blue Shield in Seattle for 13 years starting out as a claims specialist then moving into benefits area before I left and although they said they were a nonprofit, the CEO made way too much for me to feel like it should be that. Also the billings from the hospitals and doctors that we’d see were always so much more than the allowed amount that the insurance company was contracted to pay. I think it’s part the administration at both the hospitals and the insurance companies that are getting most of the money. They act like you are saving money by using insurance that is contracted with a network of hospitals and doctors but the hospitals will bill as much as possible to try to get away with that price. I’m glad that you refer to it as a Scam because it basically is. Most people say our system is just “Broken” but that doesn’t get to reality of what is actually happening. And it’s worse with Medicare, as hospitals charge even more for people with Medicare because they know they can get the money from the government for elderly people, as we need to be so careful with older people, they are more vulnerable, so they keep them in the hospital longer whether or not it’s needed. I experienced this with my dad when he had mini strokes. He didn’t have any surgery or major procedure just stay 2 nights for observation. $62,000 which Medicare paid 99% of it. I believe that hospitals definitely take advantage of the Medicare benefit. So they keep prices high and use the same ones for regular insurance. Yeah it’s definitely a Scam!
Thank you for taking up this issue, one that is not typical of your channel. The healthcare industry have our politicians and legacy media in their hip pocket, and is why this issue is rarely addressed in a meaningful way. I hope you keep up with this healthcare conversation as a regular series because those in power will not because they are incentivized to ignore this.
First of all, thank you for making this video! We need to find some solutions to this problem. I have some experience in both the USA and UK systems and have concluded there are pros and cons to both. It is really difficult to compare the two at times because healthcare is viewed a bit differently in the culture. In your video you talked a lot about urgent care, here in my city, that doesn’t really exist. Instead every neighborhood has a GP practice you register to and that is where you can go. If it is an emergency, you go to A&E (emergency room). At my GP practice, if you need to see a doctor, you have to call at 8am and hope you get an appointment and if don’t , you have to make a case to a receptionist that your case is serious enough to warrant a spot on the call list. I’ve always gotten the care I’ve needed, but it still takes some time and I have to proactively set up appointments and advocating for myself and my kids. I had both my kids here. On the other end, in the USA you have to follow up on billing and all that. Another thing to keep in mind, in many European countries the tax rates are much much higher, even if you include USA self employment taxes. So even though you don’t have to pay for healthcare, you may end up spending the equivalent or more (if you make a lot of money) in taxes. But if you don’t make much or any money, the fact you have free healthcare and don’t have to worry about that is invaluable. My last thoughts, so yes it seems like healthcare administrators or grossly overpaid in the USA but healthcare professionals are paid way more in the USA than they are here. Nurses in the USA make double to triple what nurses here make. So it is difficult to know where to start making changes, because no one, especially those in high stress jobs that requires lots of training, is going to agree to a pay cut.
I had to wait 5 months as a new patient to get in with a new primary care doctor. And very few doctors seem to be taking new patients. US and I have decent insurance through my employer. Dental costs are also outrageous and dental insurance hardly covers anything.
As a Type 1 diabetic, I can get my insulin in Asia for $7/vial, but here it's $411/vial. No difference in the quality of product. That same vial of insulin when I started taking it almost 20 years ago cost $89/vial. Yay! *note, SOME states have capped the price at $25 - 35, however many states this is not true. Furthermore, the work around the insurance companies use is to create generics of the same insulin for that price but only create a limited amount. I have only seen a generic version of Humalog 1 time. I have asked every time I go to the pharmacy. 1 time.
We came to Korea so my gf could get a dental implant. The cost difference is huge but also the hoops you have to jump through in the US is insane. We had to call insurance like 20 times to try to get the procedure approved. It took a month to get approved and then the dentist tried to schedule her for 2 months out. We went to Korea and they took her the next day. The cash price in Korea was like 1/3 the cost of the US AFTER insurance and the post-op medication was like $12.
I live in Spain, we have both public and private healthcare systems here. Public healthcare is fine for most things, but it tends to have longer waiting times. I pay 45€ a month for a private insurance that covers everything, you can get a doctor’s appointment within days and you can even use it in other european countries.
This is a very important subject. Healthcare cost is OUTRAGES! We are actually paying for the CEO's $20 million wages! Make sure you check the prices of what is covered under your insurance packages! Back in the 80s, the employers used to actually pay for your medical insurance 💯! Always check your benefit package when you become employed. Plus, not speaking negatively, but our taxes are paying for people who are not citizens nor who have not paid taxes, to have 100% coverage when we don't have full coverage. Hum bug!!😫 Actually, I have called my insurance company to see what is covered. They will tell you. Sometimes, the booklet is confusing! Other countries are worse than us! That is why they come here. You can call the hospital and tell them your situation. They will negotiate an affordable price for you to pay! Good information Shelby!! ⭐️⭐️⭐️⭐️
It is like a bad game where people are constantly changing providers when they go up, I always remember on my first day as a HS teacher principal called for an emergency meeting to inform us of new provider options as rates for hundreds of employees were drastically raised without notice the week before classes, the timing was a scam.
Australian here! Used to go to a GP where everything was bulk billed but then their appointment times slowly creeped up over the years till it was 2 weeks for an appointment (how are you meant to get a med cert for work 2 weeks later??). Switched to a private GP ~$30 a visit at the time, now closer to $50 and their wait times are creeping up. A lot of normal GPs are now charging above Medicare too. Really falls apart when you need to see a specialist, 3-6 months wait on average (though in an emergency your doctor can call directly and negotiate a quicker appointment - never had that happen so no comment). Specialist fees start at a few hundred for the consult, or you wait on the public system for 1+ years. Despite all that we do have some of the best hospitals in the world and in an emergency our costs are low-none. Our system ain’t perfect but it’s definitely not America
I think the Australian system is slowly getting worse. My sister got double jaw surgery and had to pay out of pocket (long story)...it cost her over $70k through the private system as the wait for the public system was 4 years!!
A few years ago when I was 23, I almost passed out on my way to work (probably just exhaustion). I was on the subway at the time and very spooked. Went to urgent care then a cardiologist, as referred. Ran on a treadmill for 5 minutes, received a $3000 bill a few months later as the test was “not medically necessary” despite me having a heart condition since birth. Spent the next 3 years fighting it until it disappeared.
FYI- Time based billing. The way billing works-this is not the actual face to face time with the patient. This time includes numerous other things before and after the visit. And yes it includes all the time we (health care provider) spend in your chart completing it in a timely fashion. As far as recording visits. This is highly unlikely to be allowed. In the days of defensive medicine and continuous fear of law suits this would not be allowed. Anyone can be sued for anything!!!
Excellent video. Thanks for being brave enough to air it. The problem started with Nixon when Wall Street investors pressured him to remove the legal requirement that healthcare providers like hospitals and insurance companies be non-profit. Reagan further strengthened it by making private equity interests immune from lawsuits for malpractice. Healthcare and profits are a mutually exclusive conflict of interest because there is no incentive to reduce costs. In fact, they have every incentive to increase costs as much as possible. Why are our politicians doing nothing about this? Could there be a different kind of conflict of interest going on there? You figure it out.
I appreciate this post, and this whole commentary series. As a Type 1 diabetic, I just want to clarify 1 thing. The cost of insulin was capped at $35 for seniors. Younger folks like myself would still have to pay crazy amounts. I am lucky that I have a full time job and medical insurance, or it would be $350/vial. A vial typically lasts me about 3 weeks. Also keep in mind that there are many different kinds of insulin, and they are not interchangeable. My doctor still has to argue with my insurance every time I need my insulin refilled, and type 1 diabetes is a life long illness.. it's not going away. The fact that someone sitting in a cubicle, in an office building, with no medical training gets to decide whether I need my insulin is a joke. Thank you for shedding light on this Insurance Scam Epidemic!
The simple truth is you pay much more in a private system than public because the point is to turn a profit. Though publicly funded privately delivered services are more expensive to the taxpayer, they at least have the check and balance that the government will refuse to pay for inflated service costs. The private insurance/delivery model in the US just seems set up for abuse.
Yes. Years ago I had purchased my diabetes medication for a little over $1,400 (a month supply). Then I had kidney stones and my doctor prescribed loritab (not sure how to spell, but pain meds). 150 tablets of a strong dose and it cost $9. . . $9 for addictive drugs since it must’ve been subsidized yet my diabetes drugs that I needed to live were 1,400
Also you should consider stopping going to the hot tub for a few months and see if that helps you. Hot tubs are notorious cesspools of infection especially pseudomonas and can often cause problems like these.
I think it’s crazy how adjustable the prices of healthcare costs are. I had a surgery and my copay was 8000. I said i literally couldn’t afford it and will go to a different surgeon. They eventually got it down to 1500 with just two emails.
@@Zavlon yea i agree but this surgery was considered elective surgery for a lot of other insurance companies but my insurance covered it so i took it. It should have been free though and shouldn’t be an elective surgery for any insurance plan
USA is so crazy with how heathcare is done. Its always interesting to listen to these but it is really sad. Where I live I had chest x-ray, ultrasound, extensive blood tests, consultation with a doctor and a follow up phone call and i paid 46 euros. You deserve better over there.
There was a time when in the last century when doctors used to make house calls and people paid cash for their health care. They didn't need healthcare insurance or government run clinics. Healthcare was affordable and accessible before big government and big insurance firms took over?
In early 2000’s Our premiums were $80 a month. Prescriptions $0 and I paid $70 total out of pocket to have both my boys in the hospital with 2 days of stay private rooms. That was all in 2001-2006. It was so easy to get into a Dr the same week too. 20 years & everything’s changed.
The American healthcare system is a huge scam. The people here are smart but they are being gaslight by the giant media like MSNBC and CNN to think that such horrible things like this is normal. There are many more things in this country are scam too... The reason people don't see it is because they are too busy working or too tired. The people are broken and upset because not just healthcare,,,, every things else is insanely expensive.
Excellent points. Now, imagine you have a debilitating chronic illness/injury and have extensive bills frequently. Not only do you not have time to deal with them, you don’t have energy, so you’re just screwed. 😕
Something you’re missing with the costs of procedures is that those prices don’t reflect the true cost, not even in the US. There’s a variety of factors that influence those costs, one being lack of transparency and delays in reimbursement, but in the case of other countries, those costs are artificially low do to the government capping how much can be charged, at a rate not indicative of their market value. So while it may seem cheaper on paper, it’s actually below the point where costs can be recovered, which is why access to medical devices and pharmaceuticals is much lower in other countries compared to the US. Because the US focuses on intervention, we excel in treating people when they’re sick, but fall short in keeping them healthy, whereas other countries fall short in treating people when they’re sick, but excel in keeping them healthy due to emphasis on prevention. Interventions require medical devices and drugs that cost a lot of money to develop and use and contribute to the high costs in the US greatly, but due to the probability of profit being higher in the US, most companies tend to develop them there and sell them there rather than in Europe. There’s pros and cons to everything. If you have cancer, heart attacks or a stroke, your best bet for survival and recovery is in the US, if you want to be healthy and not have to deal with those things to begin with, your best bet is in Europe.
dude im a nurse and ive had no health insurance for six years off and on bc my float position doesnt offer it wven tho i work fulltime - figure that out. So everytime I get sick from work exposures I have to pay for it myself…the scams are everywhere its getting worse and its benefiting administrators and stockholders only not mds or rns. And the regulators are all invested in big pharma. My inhaler i need to breathe is $125 here and $15 in the philippines so i used to just buy it there. I also got diagnosed for PCOS there bc drs here wouldnt order an ultrasound!. Oh and the restriction on pain meds is ridiculous now i broke my arm and had a plate put in it nine months ago and i could only be given pain meds for three months i was still in therapy and everything…. oh yeah and where I live it takes six months sometimes for a primary appointment!!! I finally got health insurance on the marketplace again recently and i was working in a pulmonary clinic last fall and the pharm rep comes in and says “no one is going to cover symbicort next year” and walks off like they make these decisions based solely on profit not on patients…
To be clear your employment arrangement did not provide any employer provided healthcare insurance. You chose not to have health insurance. No one pays for Shelby's health insurance other than Shelby. Shelby has chosen to have health insurance.
I just found out about “out of network” billings from an “in network” Hospital due to contractors. That should be illegal and considered a type of false advertising.
if you take out insurance and government the cost would be 1/10th. if you stopped using big pharma medical and used a real medical system, the cost would be 1/50th.
@@brusso456 Aka fly to Tijuana Get treated Do dumb shit and get injured Get treated And fly back All for less than the cost of getting treated in the US
I feel like ambulance fees are a scam, its usually like 3k for a 4 mile drive. Ive had to take one twice, once because a dog bite and another because a driver hit me and knocked me out while i was riding my bike.
Agreed...I took an ambulance for 6.5 miles, also after a bike accident. They charge a base fee, and then every mile ridden is an additional $65. I'm never getting in an ambulance again unless it's absolutely necessary.
I went to the ER with a bit of chest pain. They said I’m either stressed or dehydrated or anxious, told me to bug ibuprofen, and I was charged with $75
ha! 3-4 days for a primary care apt?! hold my beer - first available appointment was 3 months away, and that was me being available any day of any week.
Loved this video, Shelby. 100% agree with how messed up this system is! As a nurse, I definitely see how it’s a systemic problem with how hospitals or healthcare in general is beyond overpriced that people are going into major medical debt. We see a lot of patients that have chronic or preventable conditions but they can’t manage their health because it’s not affordable to begin with. It makes me think about socioeconomic problems- how do people hold a job, keep their home, take care of their kids, and/or get an education if their health and medical debt are preventing them from progressing?
I lived in Poland and Switzerland and can confirm the waiting times are high only for very specific operations/procedures. In Poland you can wait and get something very expensive for free or go private, pay a bit and got it within days.
Yeah healthcare is a joke. I recently had to take my son to the E.R. He got a 1700 bill for glue. He had a serious gash on his chin and all he got for the 1775, to be exact, was GLUE!
My doctor told me the US is running out of GP's because the cost of med school is so high and insurance reimburses standard service so low that new doctors have to specialize so they can afford to pay off their loans.
As a high earner, your taxes would fund healthcare in a system like the UK's or Canada's. This is not necessarily good or bad--just something to consider. You might be better off financially under the current system, while a lower earner would be better off under a single-payer system. For example, in the UK about 20 % of a citizen's income tax goes toward funding the healthcare system. Someone who pays $5k in taxes would contribute $1,000 a year. Someone who pays $100k in taxes would contribute $20,000 year.
Hi Shelby, I am from the UK, and although the service is technically 'free', we pay for it big times in terms of our overall prosperity and opportunities. It totally sucks the life out of the UK economy, and is one of the main reasons the UK economy performs so terribly compared to the US. We pay for not just in terms of our incredibly high taxes, but also lower economic growth and lower wages. There is a reason why all the most successful companies originate from the US, and ultimately these are the businesses that pay for everything. The UK economy is strangled by the NHS and unless it is scaled back substantially will lead to indefinite economic stagnation or even outright decline in the UK. Is that worth free healthcare?
@@Market-pu2fzI notice you aren't noticing the context of that the RIGHT WING government in the UK has destroyed the NHS in the past decade. Specialists get paid 40-60% in Australia than in the UK. Not hard to determine it from there.
@davidpaterson7142 that's funny my aunt and friends live in the UK and they say barring a few niggles the health system is fantastic. It includes dental, optometrist and fertility treatments and more
@@tomjones2157 if that is the case it means that your aunt and friend are on either on benefits or very low earners. These are not free for the majority of working people in the UK.
Shelby, I've been anxiously waiting for this video to drop since you announced you were preparing it several weeks ago. I and many of your other followers think that your videos are actually a public service in addition to being a source of entertainment. Health care is one of those issues that effects everyone. Please keep up the good work!
The fact that you never know how much you are going to be billed when you seek medical care is insane enough on its own.
I would argue we know our maximum out of pocket. Mine is $3,500 so that just goes in my HSA every year. After you hit the max out of pocket bills are $0.00.
You better visit Korea for medical care. Even without insurance, non Koreans are charged no more than 50 bucks for most simple procedures. One of my acquaintances had serious surgery on his intestines last year. He told me that he called an ambulance, were in an emergency room, had a serious surgery and hospitalized over night. He got billed only 800 U.S. dollars. Lol. He is a Korean American. One reason I never consider immigrating to U.S. is because of medical bills. It is brutal. I notice more Americans are visiting their friends and families in Korea and take opportunities seeing doctors and getting treated here because it is much cheaper. Me? If I see a doctor with insurance, it will cost 5 or 6 dollars. LOl.
@@lesleyt7438Depends on your plan. After the deductible, our plan covers 75% of the bill thereafter.
@@lesleyt7438I hit my maximum and I still had to pay
Modern scam of life: 1.17 mil starter home 😂
My nephew died because he didn't want to go get his leg checked out. He was saving for a down payment for a house and didn't want a big bill. It was a blood clot. He died putting his boot on to go to work. He was 26
VAXXXED?
did he get the jab?
I had a student coworker at the Library in college who died when she had stomach pains. Didn’t get it checked because she didn’t have insurance, and died overnight. That was at a time where you fell off parental insurance at a young age, I think 21.
im so sorry for your loss
@@brusso456you’re disgusting.
It’s definitely a scam! I had a miscarriage about 2 years ago and went to emergency room for it. They did an ultrasound and that’s just it. Billed me $3000 with insurance!!! 1 year later I gave birth to my baby, got billed for $3000 for uncomplicated labor and delivery with insurance. So that ONE ultrasound to check the miscarriage is the same cost of 2 days in the hospital?! It’s crazy!
wtf that’s soooo wrong!
Did you call your mother, aunt or grandmother first? They would've helped you decide if you needed medical attention. To them, miscarriage was part of their child-bearing years. A nurse midwife is also a person to contact.
Right. Because you're not just paying for your own medical coverage, you're paying for everyone's medical coverage thanks to the ACA. Hope everyone who voted for the mess we have today realizes this.
@@TeddyLeppard Actually the ACA is the best thing that could've happened. The system is set up so that people that make a lot of money pay for people who don't.
The cost of giving birth a baby in Spain in a public hospital? “Nothing” (you pay in advance with higher tax including income tax, VAT/Sales tax,….)
Even 15 years ago my primary care doc said to me "the health insurance companies don't really care about your health." He was not wrong and I always keep that in mind.
I'm South Korean. My dentist quoted me $1k to get 1 wisdom tooth removed, *with* insurance. I went to South Korea to get my wisdom teeth removed. They removed 3 and charged me $50, without insurance. I would rather live with an injury in the United States rather than get medical care.
Wow that’s smart!
It’s subsidised for citizens right? Can’t imagine that is how much it actually costs to remove 3 wisdom teeth, seems like pretty involved procedure.
@@disarchitected
The US subsidizes the South Korean military. We also operate US military bases and station US troops in S Korea. So their tax dollars are available for healthcare.
I got an emergency healthcare from when I was travelling there. The quality of care was amazingly high. I felt like I was in a private clinic in Beverly Hills. The medical technique used was the state of art. When I got the bill, I was really blown away. It was so low, I just paid out of pocket rather than going thru my US based insurance. The whole experience literally blew my mind.
@@ShelbyChurch 🫡
Shelby - you are 100% right. As a physician in the U.S. for the last 17 years, everything you described is happening and I see it on a regular basis. But it’s even worse than you know. More physician practices are being bought up by healthcare systems, contract management groups, or corporations owned by private equity. If you speak out about it, you are sued, fired, blackballed, given a disciplinary action in your employment file, reported as “disruptive” to regulatory boards, or a combination of these. I’m not talking about disinformation that has become rampant since COVID but rather the profiteering by rich business people and politicians on the back of patients, doctors, and nurses. I’ve even had these same insurance issues (as a physician who knows the system!) that you have, including a surgery from last year. There’s a great explanation of private equity in healthcare by More Perfect Union. There’s also a great book about the history of US healthcare called The Social Transformation of Healthcare. The author wrote it in 1983 with predictions. He did an updated 2nd edition with an epilogue. Almost all of his predictions from 1983 came true. Happy to discuss this more and in exquisite detail.
Much of that is why I’ll never work as an RN in the US again. The rest is because when i broke my back i couldn’t get care. No one took me serious. 10 mos later got sent for STAT MRI r/o cord compression. Talk about system failure. 😞
I worked for Humana Inc. for 12 years and let me tell ya, it’s all sickening once you see the behind the scenes and negotiations.
Awh damn😭 I just signed up for Humana. Do you have any recommendations for me?
🤣@@savvyyddd you just cracked me up.
More like Unhumana
I had heart attack and stayed over night just one night with cath procedure for just one stent...total cost 260k !!! Ambulance alone is 3000 for one trip under 5 minutes!! Shelby please go into politics and fix this! I will vote for you!!
Same happened to me in Denmark. Cost 0,00 dollar. Sorry it happened to you. Vote blue to change the madness
id love to move to Finland I really like the vibe @@kimkristensen2816
Did you have health insurance?
Politics are the cause of all this mess tbh...pharma companies are endorsing politicians to push their products onto the market just for profit
Usa health industry is eating its own tail , up to the neck , not a good look
When retired couples have to pay on average $300K on healthcare expenses throughout their retirement, the entire system needs a major overhaul. This commentary series is my favorite thing to watch so thanks Shelby
My financial planning tool estimates we will spend $300K EACH over our retirements. So $600K for the two of us. It is costly for sure. The good news is our retirement plan is still projected to succeed for 99% of future scenarios, but it does divert money away from fun things.
I came into retirement with my financial eyes open. What I was unprepared for was the amount of time I'd need to spend on the phone resolving one issue or another. The complexity of the system is a huge time sink.
Healthcare is single handedly the biggest crisis, scam and misunderstood aspect of life.
These are war mongers they are making very much what wars are conjured up from
Well, that's what happens when you allow a revolving door between corporations and government.
Corporations come up with the schemes and government does the gatekeeping.
3 month ago I was in Bangkok, Thailand and got sick. I asked the hotel staff on if there is a hospital around. They managed everything for me. A cab picked me up from the hotel, cost $1.50. Went in front of the hospital which looked more like a high end resort. A person opened the car door and walked me into the hospital to the front desk where I was greeted and offered a bottle of water. I gave them my passport and they filled out everything. After sitting down for 5 minutes, they gave me a paper and sent me to the 7th floor to see the specialist. Before that a nurse did a full check of things. The doctor was good in English and I explained my situation. He checked me out and prescribed me the medicine. The hospital had a pharmacy on every floor. I went there, gave the person my paperwork and 5 minutes later I had the medication. Overall, it took about 60 minutes from start to finish and cost me $35.00.
At a hospital here in the US, you can't even get Tylenol for that amount. 😤
The system of PUMPING MONEY out of citizens who find themselves in a difficult situation cannot be called a HEALTH CARE system.
This is how private medical care works in most countries around the world. US is the only developed country without universal healthcare or mandatory universal coverage.
My parents are in their 70s & rarely go to the doctor because they just can’t afford it. My mom, who’s never been in great health, said she purposely avoids going because, if they find something that requires treatment, they can’t afford it anyway. This s**t makes me so angry, and so sad.
This makes no fucking sense
They should be on Medicare. If they have a supplemental policy (plan g) to go with that, the only cost should be a $240 Part B deductible. Of course, there's a $174 monthly premium for Medicare Part B taken out of their Social Security check and another $125 for the part G supplemental policy for a total of around $300 a month.
My dad told me that over twenty years ago your employer paid more into the employees health insurance. Now the employee has to pay more.
my company contributes 1.75x of whatever I do... but it's also a Dutch company. but I work in America so there are definitely better options out there. but totally agree it should be standard
Yep, so essentially they keep your salaries low partly because your money is going to pay for that health insurance that the employer supposedly pays for you
Back in the 90s a lot of companies paid for your health insurance completely and nothing came out of your paycheck. In 2002 I got a job where they wanted $100 out of each paycheck for health insurance and I was so confused and thought it was a scam.
@@SteveWiIIDolt Yep, exactly, when I started working companies paid for your insurance completely. Now it's very rare, haven't seen a company yet that I have worked for that doesn't do it for free anymore. On average I find about I pay about $50 a week to pay toward Dental, Health and Vision, with Health being like 95% of what you pay for.
I don’t like the loud noises in the USA 🇺🇸 and the people are plain rude and pretentious
I’m in Canada and had a colon cancer diagnosis 5 years ago at 28 years old. I had many procedures, a surgery(within 2 weeks), 6 nights in the hospital, bloodwork every 3 months and yearly CT scans, ultrasounds and I didn’t pay a dime for any of that, never even saw a bill! I have extra coverage through my employer and for prescription meds I only pay a $3 dispensing fee. Not everyone has a positive experience, I work in healthcare and I see everyday how the system in Canada def needs a thorough overhaul. Waits for non urgent/elective ortho surgeries is outrageous for one. Many people fall through the cracks but I would never trade our current system with its flaws and all for the American Style healthcare system. I am extremely thankful to live where there is universal healthcare.
Years ago, while travelling to the US, I had really severe tonsillitis and I had to go to see a doctor. He told me that if I was a US citizen, he would’ve sent me straight to the emergency room, but because it would be so expensive, he instead put me on a high dose of antibiotics so that I could fly home. All up my care in the US cost me AU$800.
Upon going home, I went to emergency in an Australian hospital and saw a doctor, bought another course of antibiotics and all kinds of painkillers and it cost me a grand total of $21.
Again, it's pointless to compare countries. There are too many different factors at work. In countries with socialized medicine, people are STILL paying a lot of money for "free" services, but it has been folded into the much higher taxes they pay their government.
@TeddyLeppard
At the same time, people see their taxes doing actual work. Meanwhile, US taxpayers are paying for thousand dollar toilets for the air force
It actually cost you a lot more than $21. You were taxed at a much higher rate than we are in the USA and that paid for the health care system. You just paid it over your lifetime rather than all at once.
I work in a pharmacy and it blows my mind how a drs only prescribe a pt something BECAUSE they NEED it and the ins will reject it, requiring a prior authorization from the dr telling them that they NEED it 😩
Prior authorizations are out of control. We need legislation to restrict this practice.
American in Mexico: I had a freak'n tumor in my head and it took over 6 months to be seen in the USA!!! I had insurance and it was over $800 just for the MRI. I haven't had to go through anything serious in Mexico, but a normal doctor visit is less than $3 and you just show up (walk-in clinics)..without insurance! It's less than $40 for a filling...no insurance! It was around $75 for the OBGYN for pap smear, ultrasound, HIV test (they really give you a thorough exam)....no insurance!
Oh, I forgot to mention...you know the price before you go!!!! You can literally look up how much it is for lab work or an X-ray...no surprise bill 5 months later!!
I need to learn how to go to the doctor in Mexico 🤔
@Jhaele hire an armed bodyguard so you don't get kidnapped
@@tomjones2157This ain’t a movie
@@tomjones2157 It's probably cheaper to hire a bodyguard than it is to pay the medical bill.
Our “urgent care” facility here in AZ now won’t take walk-ins. You have to make an appointment they have 1-3 days out. It’s a mess. We need corporations and insurance out of healthcare.
How is that "urgent care"?
I would think them being in direct competition with Mexican clinics would drive prices lower
We do. This is dangerous and not cool. Doctors nurses patients - no one benefits. What do we do?!?
A relative of mine is an executive at Cedars Sinai in Los Angeles. In a casual conversation, she said that their hospital is "non-profit" in name only. The parking garage for execs and top docs is full of very expensive cars. She had to ask one colleague why he was parking his McLaren sports car so that it was taking up two spots. And while the MD's are obviously well-educated in rigorous college and grad school programs, some of the top execs went to mediocre state universities with majors like "healthcare administration" which don't seem rigorous or competitive at all.
as an endocrinologist the cost of insulin riles me up so much!! we let insurance companies make massive profits off this medication while I have many patients who just cannot afford to pay for it, and then later get admitted to the hospital because their diabetes is out of control. thus increasing their costs (and taxpayer costs) even further! it makes absolutely no sense and just feels so unfair.
edit - whoops, accidentally replied to a comment instead of the video!
but to actually reply, a great minority of doctors are making enough money to get a fancy sports car. plastic surgery, neurosurgeons, yes, but most of us have an insane amount of debt and thus live middle class or upper middle class lifestyles. thus why there is such a shortage of doctors - why do insane training for 10yrs of your life and make less than many of classmates who got job straight after college
yes im a nurse and i think its CRAZY that ppl can get those degrees and literally just step into the healthcare ladder and run things its NUTS!
@@DrMichellePonderAmen!! It’s not all insurance companies dictating this though. I work in contract negotiation at a health insurance company. Hospitals (especially specialty hospitals like cancer facilities) expect almost a 2000% pricing increase for CHEMO and RADIATION. That is DISGUSTING. And the worst part of this is that the patient cannot receive the necessary care until the health insurance company accepts this horrendously gross charge from a “hospital”.
you and they dont know what non profit means lmao and they work there lmfao. of course they all get paid handsomely thats where the money goes and at the end there is no profit for the hospital they spend it all on themselves or equipment dummy.
Work smarter, not harder.
Doctor here- I have more detailed vids on my channel about this but you're absolutely right that healthcare in america is a ripoff. To weigh in on the 45 minute appointment charge on the billing- you are right that they did not spend 45 minutes with you but they likely were not billing on time but on the 'moderate MDM' (mdm = medical decision making) portion. A lot of billing codes providers use act like this- they can be used to bill via time spent or complexity of care. You cannot tell based on the bill as it is but you can tell from the note they had to write- if they do not have a portal for you to see your note, thats technically illegal now but some hospitals havent caught up- but you can ask for note to see what they wrote. If they wrote something along the lines of 'I spent >45 minutes with greater than half the time spent face to face with the patient' then they were billing based on time. And based on how much time you said they spent, they did not meet that.
More likely however, again they billed you based on complexity of MDM because we are not good at keeping track of how much time we're in the room with a patient. In your case given you are young and you went for what should have essentially been an urgent care visit, they should not have charged you for moderate MDM. If you get a copy of the note and there is nothing that mentions time spent (if it does, its your word vs theirs and admin will fight you on it) and the assessment and plan typically at the end of the note simply has something like #sinusitis and what they did (not a lot) with no other problems then at best they should have billed Low complexity MDM (99203) or even more appropriate is straightforward complexity (99202). If that is the case you absolutely should argue for your visit to be re-coded.
Most doctors, PAs and NPs get little to no training on medical billing and have no idea what the specifics are for billing codes they use a lot. Most likely the provider you saw only ever bills moderate or high mdm for new patients and that works for 90%+ of people they see on a daily basis and for the ones it doesn't, they don't fight it.
With regards to the recording aspect, you definitely would need to legally ask before doing so- I personally would have no problem with it though I know many colleagues who would be uncomfortable with it- that being said you're within your right to do so, and until healthcare in america is better (not holding my breath, I'd die) thats probably the only way you will have proof to argue with more than just your word vs theirs.
Last time I went to Urgent Care, they charged me $652, for them to tell me to go to the emergency room. I was only there for a total of 15 minutes, which 10 of those minutes was sitting in the waiting room. While in the hospital recently, it cost me $2000 a day for my room and I had to pay New York state $250 dollars surcharge for staying in the room.
This is really really scary
I have lived for most of my life in the US but during covid, I went to Poland and got stuck there for 4 months. While I was there, I got injured. Went to a private specialist( $25) within a week and got an MRI, privately- as in I had to pay out of pocket, and it cost $100. Once I came back to the US my injury came back after 6 months and it took 2 weeks to see a specialist. The doctor saw me for less than 5 minutes.
Also in the US I had a friend coughing up blood for a week. She went to the ER. They told her they couldn't do anything and to see a specialist. They even gave her a referral. It took 6 weeks to get an appointment. We live in an area with over 100 hospitals.
I lived in that country for years. Nothing is free, and you need to wait years in line to get to specialist. My friend in PL was shocked that I got to orthopedic within 3 days in US with child collar bone when she had to wait 6 months with her broken leg child. So a lot people have to go pay private and it's expensive for them. Everything is way more expensive for PL people that to you. And I hope you didn't experience standard hospital care, that is way way below US standard. I experienced both so I know what I'm talking about
wow i broke my arm on vaca here in the US it was $2500 for ER, $500 for ortho surgeon, $2000 down for the surgery, and I still owe $17,000.
@@AnnJo24224
Your friend's child (in Poland) had a broken leg ... and had to wait 6 months to get it 'set'?
This is horrible and medieval.....
That's nonsense@@factsoverfiction7826
This is why i love traveling abroad! I do all the visits..vision, dental etc ...blood work ...it is still cheaper to fly, stay a few day, and see drs all together than it is here in usa ..its crazy
Shelby, thank you for making this video. I work in contract negotiation and coding at a health insurance company. Many people do not realize how much medical facilities (especially specialities like cancer hospitals) will jack up prices and require insurance companies pay up or else the patient will not receive care. A smaller group funded health insurance company canNOT afford to pay a 2000% mark up on $300,000 for cancer care. Imagine the stress on all of those involved due to the greed of these facilities. Most importantly, that poor patient who is essentially being held hostage in all of this. Also, I’d really be shocked at a non-profit not performing care for ectopic pregnancy or a d&c for a miscarriage :( so so so different from an abortion in many ways, despite coding.
Getting healthcare in the US is basically buying a subscription to get a coupon (insurance) that you don't know how good or bad the value of that coupon is. 😖
The USA is actually the only developed country that has failed to implement Universal Health Coverage. UHC is basically a system that allows people to get health services they need in a timely manner and without financial hardship. The first UHC systems originated in Europe and this is why our healthcare is so much cheaper even now in comparison to USA. While it is based on values of social equity, it is not »socialism« (which sadly lots of Americans still think it is). Due to the lobbying efforts of private industry (mainly private insurance companies and pharma/med device companies), the US has not been able to push through a comprehensive UHC system politically.
Medicare, Medicaid, and VA coverage are some examples of trying to establish UHC but they are still very much limited in scope and also (!) they each operate on a different payer system which makes them even more difficult to align.
In most European countries, essential healthcare is covered through tax system - and it doesn't matter if you are fully employed or doing freelance gigs, everyone who does any kind of work pays taxes on usually a monthly basis and thus has access to healthcare system. The countries usually also regulate insurance, medication and medical devices costs so the private industry is not able to inflate them like in the USA.
And while healthcare in Europe is not perfect (we are also facing lack of health workforce, long waiting times, etc.), we don't experience »going broke after visiting a hospital« so people regularly go for check-ups and other procedures, including preventive services. This helps keep the population healthier and is also one of the reason why US is stuck in this weird loop leading to bad health outcomes of the population.
I’ve had some loved ones get screwed over and receive horrible medical treatment through the VA. Some have received great care for smaller concerns. I personally do not trust the VA, and this has caused me to lose trust in the idea of a UHC model in the US.
@@ahhitskatie9094 Yep, American demographics and open borders do not allow for UHC, and seen with recruiting crisis, they don't even allow for a military.
VA and open borders are not good reasons not to have universal healthcare
@@churblefurblesthose are not the reasons for not having universal healthcare. Europe has open borders, but still provides care for their population and visitors. I had to see a doctor in France - paid 20 euros because I was a tourist, otherwise their system would’ve fully covered the cost. I don’t think Americans even understand how it is possible to get medical care for that cheap or actually free, covered by taxes.
You should reach out and talk to Doctor Mike about this! maybe a little podcast episode or extended version of this!
Thank you for covering this!! Over the past few years, I was the sole caregiver for a terminally ill family member, who ultimately passed, and we spent $100K+ on just one year's worth of medical care, even though they had 'excellent' insurance by US standards... Had they lived longer, it would have bankrupted them altogether (which is sadly the case for SO many Americans). If you're keen to do another deep-dive video, I think it would be really interesting to take a look at the cost of rehabs and nursing homes (and the enormous upfront costs of long-term care insurance). I think the country's in for rude awakening as the Boomers age and we continue to have a shortage of medical workers...
Greedy Parasitic private equity has bought nursing homes, hospitals, dentists, vetrinary hospitals(we treat our pets like family) air ambulances($30,000- $600,000 AFTER INSURANCE PAYS)
They buy up anything that is a human need.
Healthcare is an INELASTIC GOOD, YOU WILL BANKRUPT YOURSELF AND YOUR FAMILY TO STAY ALIVE. AND THE ENTIRE HEALTHCARE SYSTEM KNOWS IT.
Phew!
Hi Shelby, Justin from Canada here. Our healthcare system is falling apart.... the government (provincial and federal) are letting it happen - heading towards privatization (for profit) like the US. As a healthcare provider myself, it is sad, and as a tax paying citizen it is beyond frustrating, and scary to think about what our healthcare will be like when we get older and need it the most.
Yeah. There are groups of politicians and parties profiteering from privatizing our Universal Medicare system. It's really sad.
oh really? didnt know we were heading there. I'm sure a lot of Canadian will get pissed if we become like the US so I doubt it will ever get there
@@grapesyropAmericans have been pissed about healthcare for years. It didn't stop anything from happening to us.
don't think so. Canada and the UK have fatal ER wait times where people are dying in waiting rooms waiting for urgent medical treatment. The French and Australian health systems are the best where they combine Public and Private healthcare. Then again Americans subsidize the world's health care as most of the world's medical innovation comes from the U.S. and China is at a distant second and by distant I mean by a galaxy away.
@@grapesyropit will. They can scream as loud as they want. In Canada, 2020 & 2021 were the proof.
Being a 10 year resident of Canada, I know that if you are SICK and need a doctor, you are seen. I needed a referral to a specialist and was seen in less than 2 weeks. My primary care doc will do phone appointments and you can book one of these within a few days. We also have walk in urgent care. Having lived in the US most of my life, I am fully in support of Canada’s health care system. I have been well taken care of here. ❤
BUT, elective surgery can take months. Canada prioritizes people that are sick, injured and need treatment.
I'm Canadian and it's funny to me because we basically have the opposite problem. I know TONS of people who have flown/driven south to the states to seek care because the wait times are just too long in Canada, especially when you need life saving care. While ours is "free," for the most part (due to very high taxes), a lot of us can't even access it and those who have the privilege of having money will access it in America. Wouldn't it be nice if it was both affordable and available to us both!?
agree!! a girl in my town (i'm in NL) just posted a picture of a letter from our local hospital with an appointment for an MRI. her doctor sent the request in september 2023 and her appointment is for september 2026. people are literally going to die before they can get diagnosed with anything at this rate. i'm lucky to have a family doctor (i think more than half of the province doesn't?) but mine usually takes anywhere from 1-3 weeks to see. so frustrating
I am very surprised. I live in Quebec and I thought we had the longest wait times in Canada, but now that I read you, I will think again... This is so terrible. @@lilkrissyy
This is such a good conversation. Something to add is when we talk about America being so unhealthy while simultaneously talking about our expensive healthcare system, we have to connect the dots here. that if you are unable to access affordable healthcare for your yearly screenings, preventative care, and ongoing treatment of certain conditions (like affording your prescription meds to manage a poor lab value to prevent it from getting worse). The social determinants of health are so often overlooked, then people are blamed and shamed for their health conditions that are lifestyle influenced, but if you don’t have access to affordable/accessible care, that plays a much bigger role.
@shelbychurch Patient: "I need stitches."
UK health system: "Your appointment is in 43 months."
US health system: "Your bill from 18 different agencies will be $77,000."
Canadian health system: "Have you considered dying?"
yeah no.
Nonsense
😂
My husband broke his leg in a ski accident and the insurance company said the total cost was $150k and we only had to pay 7k. Yay. lol this is a scam. I even drove him from the ski hill because we didn’t want to call an ambulance since they cost so much. So sad we all have to think this way 😢
Shelby this is one of the best conversations to be had. Healthcare in America. Why is it so costly and Why shouldn’t everyone person know the cost of services up front? Nicely done Shelby.
There was some guy who worked in the US healthcare system who told me I was clueless when I remarked what a mess it was. He thought it was the best system in the world because the ultra rich fly over from other countries to the top private specialists and that there was no financial concern because if you almost die and end up in the emergency room, they have to treat you (never mind the fact that you have to go into debt to pay for it). These people are insane.
I heard a Dr. say that 95% of patient visits are for things the patients could deal with at home themselves.
I'm 59 and take good care of myself. I've never had HC because I can't afford it even with employer contributions.
I'm so glad I was smart enough to take care of myself and not fall for their scamming BS.
I was a caregiver to a sick parent and the way her GP scammed her was atrocious. A total con artist. But she insisted keeping him.
People need to open their eyes and see how bad of a scam it all is. Especially GP and emergency room prices.
most Americans go to the doctor over the mild flu.
Oh I work in pediatrics and did a stay in the ER and let me tell you...the amount of "oh my kid has a fever" patients that come in...yes they look like they're breathing a little fast but that's a sign of fever...kicker is the parents never seem to give them meds, their excuse "I wanted you to see the fever" we'll just give them meds and send them on their way.
Ozempic in Poland - 97 dollars, Ozempic in the US - 980 dollars. EXACTLY the same thing! How is this even legal? It is much cheaper to fly to other countries for medical care. Why isn’t medical tourism a huge industry yet?
The cost of the Ozempic in the US is 980 dollars, in Poland, 97 dollars, and in my country, Slovakia, 0 (zero) euros.
@ zero price because you are a citizen. Is it zero for tourists too?
@@00_UU Yes, it is, if u have travel health insurance, which our country offers for the tourists, who are staying in Slovakia longer.
@@justtennischannel2 how much is Ozempic price in Slovakia without insurance? Travel health insurance is not always good. I had a bad experience in the past
I worked for Cigna years ago, it was the worst job I've ever had. Insurance companies are hardcore, they are the judge, jury and Executioner. Good luck trying to appeal anything, they are all about profits. Some people don't understand that most businesses are self insured, which means it's in your Employers interest to get claims denied.
I remember needing to get my wisdom teeth removed by a surgeon and my insurance didn't want to pay for anesthesia even though is literally necessary to do the procedure. I had to argue with the people on the phone. Just ridiculous...they ended up covering it at the end of the day. Also I cant believe the head of these hospital systems are making so much money...20mil a year is crazy!
no one deserves 20 million per year, it's outrageous!
@@lindyralph8792 Its how they pay the Michelle Obama type sinacures.
i had a tooth pulled without anesthesia before. it almost sent me into a seizure and caused my death. that big of a shock directly to a cluster of nerves in your head can easily kill you.
I agree that it is now taking FOREVER to see a doctor in the US.
Singaporean here.
I have not experienced the actual US healthcare when I was there for holiday, and the "closest" one I encountered was in a CVS pharmacy in Vegas. So my mum was sick and they prescribed her some really strong painkillers (can't remember the name, but in short - the painkillers were useless lol, the paracetamol I brought from Singapore worked so much better), and if I am not wrong, we paid over $20 for that tiny ass container, and we were so shocked at the cost.
Years later, I had a conversation with an American tourist at my workplace (I used to work in luxury fashion before my current job) and she summarised the American healthcare system with this sentence "The healthcare system in America is literally commercialise for profits, and only the rich have access to such treatments." She even told me she would rather fly to Singapore for medical treatments, as our healthcare system is "more affordable" for them. I now work in a public hospital, and I notice a number of foreigners seeking medical treatment in our public hospital for various treatments to even expectant mums delivering their child here, even though they pay more than a local.
@chervywong96 Its not the problem, singapore has strict demographic controls to reduce the burden.
@@churblefurbles Not always the case. There are still rare cases of people accumulating hospital debts, despite all the financial aids available for those in need
@@churblefurbleswhat is not the problem? American healthcare is a ripoff, Singaporean is not. What else to say?
I went to an urgent care about 4 years ago.
I already knew what was wrong, so let them know.... I got a shot and paid 200 for it. Took less than 30min and spent the majority of the time waiting around.
A few months later I received a bill for 1300, I managed to get it tossed out after calling the billing number and telling them I won't pay for it since I asked upfront if the 200 was the entire bill. The entire think felt like a scam when I was on the phone.
It’s all scam
I can’t afford insurance in NYC and when I had pneumonia, I ended up in the ER for a steroid and was billed $3k. Our whole system is a scam. Great video Shelby!
Great to see you here Justina!😄
This is so bad I wish you the best
Correction around 13:30, I just graduated with a bachelors degree in healthcare administration. A not for profit hospital still needs to profit money otherwise it can’t run. Only real big difference between FP and NFP is tax exemptions. Both FP and NFP need to profit money in order to service patients.
The system is terrible, and don't get me started on wanting to escape - because that's when they get you with the citizen based taxation so you are literally trapped. Being an American is a curse right now, which is a shame because if certain things were tweaked like healthcare and food that isn't filled with chemicals/pesticides, mandated PTO, sick time, paid parental leave and an actual pension for when we are old, and more - it would be a decent place to live. Currently as it stands - this country is a hot mess.
Actually IRS gives you a foreign income exception or something like that. They refund around 140k of your annual federal income tax and this cap gets higher every year. So unless you are getting paid way more, you are good to live abroad. It is a good idea actually, just healthcare and good fresh food are good enough reasons to live in Europe.
The graph at 1:29 says it all. America is the only developed country without socialized healthcare. Congress is ruled by lobbyists and the private-healthcare lobby is a BIG one.
Hi Shelby,
This took place over 10 years ago .
My first job right out of college was 40 hours but no medical insurance. Then I got a cold which gave me a severe sore throat, I went to a small no name clinic and they gave me a test for penicillin bc I didn’t know if I was allergic. When I tested negative, I got a shot of penicillin and my throat cleared up in 30 minutes but I felt very sleepy. Love that clinic. The wait was 5 minutes and I saw a doctor. I wish there was more of this kind of clinic. I was going to pay whatever and it came out to 20 dollars.
I ended up going to the hospital a week after a car accident I was in. It was a hit and run and my neck and back hurts really bad. I don’t have health insurance. I went to the hospital with the intention of getting a definitive answer as to whether it was just whiplash that will go away, or if it’s something that may be much more serious…. There was absolutely no diagnosis that took place. I didn’t even change out of my personal clothes into a gown. Doc gave me one Lidacane patch, one ibuprofen…. I ended up getting a bill for $1400!!!!! I still am in loads of pain and do not know if I have a broken back or slipped disk or lifelong spine damage… $1400 for one ibuprofen pill and one pain patch🤬🤬🤬
As someone deeply entrenched in the health insurance industry, I can't help but acknowledge the exorbitant costs, absence of pricing regulations, and opacity in the system. However, the issues extend far beyond just the point-of-service aspect. Much of the accessibility promised by the Affordable Care Act has been distorted by the maneuvers of insurance giants and hospital conglomerates. It's akin to what we've witnessed in other sectors-universities, lenders, and Congress wrecking the economy with college debt. It's a harsh reality that calls into question the integrity of the healthcare system in America, the financial institutions we trust and Congress selling the country to profiteers.
a hospital tried to charge me $80 for asking a simple question about my health while i was at a simple physical checkup covered by insurance. i still have not paid and dont plan to. scummy shit, just insane what these places pull on us
yeah depending on what is discussed during the visit they can and will bill you more, even if it’s just a simple question. learned this in PA school and it’s the tip of the iceberg when it comes to healthcare and billing
@@Archchill learned the hard way, if they weren't scummy POS they would have told me I'd be charged for it though and then I would've told them forget it I'm feeling amazing actually. I didn't get anything extra and didn't take more of their time up than the physical I was there for.
Regardless, it won't be paid.
You need to threaten them that you will report them to your state medical board.
@@TheSpicydiva i agree with you guys that it’s terrible, but reporting them to the state medical board won’t accomplish anything as it’s fair game under the current rules. As for telling the patient that asking certain questions can raise the bill, well that just opens a whole can of worms where the patient might have questions about that thus taking up more of the providers time to even as far as the patient withholding information due to fear of being billed. the entire system needs and overhaul, from scratch, but that won’t happen because certain people are making too much money. look up how much the hospital administrators, directors, and president are making and then ask yourself what exactly are the individuals contributing to the hospital? Look up how much the CEOs of insurance companies like united healthcare are making? how much the pharmaceutical execs are making. look at how much is being spent on lobbying by these people/industry. then it all makes sense, and you’ll see why nothing will change.
TLDR: its really not your providers fault
I really liked this video. I worked for Blue Shield in Seattle for 13 years starting out as a claims specialist then moving into benefits area before I left and although they said they were a nonprofit, the CEO made way too much for me to feel like it should be that. Also the billings from the hospitals and doctors that we’d see were always so much more than the allowed amount that the insurance company was contracted to pay. I think it’s part the administration at both the hospitals and the insurance companies that are getting most of the money. They act like you are saving money by using insurance that is contracted with a network of hospitals and doctors but the hospitals will bill as much as possible to try to get away with that price. I’m glad that you refer to it as a Scam because it basically is. Most people say our system is just “Broken” but that doesn’t get to reality of what is actually happening. And it’s worse with Medicare, as hospitals charge even more for people with Medicare because they know they can get the money from the government for elderly people, as we need to be so careful with older people, they are more vulnerable, so they keep them in the hospital longer whether or not it’s needed. I experienced this with my dad when he had mini strokes. He didn’t have any surgery or major procedure just stay 2 nights for observation. $62,000 which Medicare paid 99% of it. I believe that hospitals definitely take advantage of the Medicare benefit. So they keep prices high and use the same ones for regular insurance. Yeah it’s definitely a Scam!
Thank you for taking up this issue, one that is not typical of your channel. The healthcare industry have our politicians and legacy media in their hip pocket, and is why this issue is rarely addressed in a meaningful way. I hope you keep up with this healthcare conversation as a regular series because those in power will not because they are incentivized to ignore this.
First of all, thank you for making this video! We need to find some solutions to this problem. I have some experience in both the USA and UK systems and have concluded there are pros and cons to both. It is really difficult to compare the two at times because healthcare is viewed a bit differently in the culture. In your video you talked a lot about urgent care, here in my city, that doesn’t really exist. Instead every neighborhood has a GP practice you register to and that is where you can go. If it is an emergency, you go to A&E (emergency room). At my GP practice, if you need to see a doctor, you have to call at 8am and hope you get an appointment and if don’t , you have to make a case to a receptionist that your case is serious enough to warrant a spot on the call list. I’ve always gotten the care I’ve needed, but it still takes some time and I have to proactively set up appointments and advocating for myself and my kids. I had both my kids here. On the other end, in the USA you have to follow up on billing and all that.
Another thing to keep in mind, in many European countries the tax rates are much much higher, even if you include USA self employment taxes. So even though you don’t have to pay for healthcare, you may end up spending the equivalent or more (if you make a lot of money) in taxes. But if you don’t make much or any money, the fact you have free healthcare and don’t have to worry about that is invaluable.
My last thoughts, so yes it seems like healthcare administrators or grossly overpaid in the USA but healthcare professionals are paid way more in the USA than they are here. Nurses in the USA make double to triple what nurses here make. So it is difficult to know where to start making changes, because no one, especially those in high stress jobs that requires lots of training, is going to agree to a pay cut.
They can't take a pay cut, they still have hundreds of thousands of dollars in student loans to pay off... The whole system is screwed.
This video is great. Healthcare here in the states is so frustrating. So much scams going on
but its not, all these videos miss the point, without the correct demographics you cannot have nice things.
I had to wait 5 months as a new patient to get in with a new primary care doctor. And very few doctors seem to be taking new patients. US and I have decent insurance through my employer.
Dental costs are also outrageous and dental insurance hardly covers anything.
Thank you for bringing attention to this. This is a major issue that not many people quite realize.
As an American, I feel the US has fallen to a developed nation status.
As a Type 1 diabetic, I can get my insulin in Asia for $7/vial, but here it's $411/vial. No difference in the quality of product. That same vial of insulin when I started taking it almost 20 years ago cost $89/vial. Yay!
*note, SOME states have capped the price at $25 - 35, however many states this is not true. Furthermore, the work around the insurance companies use is to create generics of the same insulin for that price but only create a limited amount. I have only seen a generic version of Humalog 1 time. I have asked every time I go to the pharmacy. 1 time.
Here In India it will be like $4/vial
We came to Korea so my gf could get a dental implant. The cost difference is huge but also the hoops you have to jump through in the US is insane. We had to call insurance like 20 times to try to get the procedure approved. It took a month to get approved and then the dentist tried to schedule her for 2 months out. We went to Korea and they took her the next day. The cash price in Korea was like 1/3 the cost of the US AFTER insurance and the post-op medication was like $12.
Korea has such a good medical system 🙌
I live in Spain, we have both public and private healthcare systems here. Public healthcare is fine for most things, but it tends to have longer waiting times. I pay 45€ a month for a private insurance that covers everything, you can get a doctor’s appointment within days and you can even use it in other european countries.
Thank you for making this video. People in the US need to know about our crooked healthcare system. Politicians have to do something about it.
This is a very important subject. Healthcare cost is OUTRAGES! We are actually paying for the CEO's $20 million wages!
Make sure you check the prices of what is covered under your insurance packages! Back in the 80s, the employers used to actually pay for your medical insurance 💯!
Always check your benefit package when you become employed.
Plus, not speaking negatively, but our taxes are paying for people who are not citizens nor who have not paid taxes, to have 100% coverage when we don't have full coverage. Hum bug!!😫
Actually, I have called my insurance company to see what is covered. They will tell you. Sometimes, the booklet is confusing! Other countries are worse than us! That is why they come here. You can call the hospital and tell them your situation. They will negotiate an affordable price for you to pay! Good information Shelby!! ⭐️⭐️⭐️⭐️
It is like a bad game where people are constantly changing providers when they go up, I always remember on my first day as a HS teacher principal called for an emergency meeting to inform us of new provider options as rates for hundreds of employees were drastically raised without notice the week before classes, the timing was a scam.
The fact that some people are just realizing now the health system doesn’t work is terrifying on its own.
Australian here! Used to go to a GP where everything was bulk billed but then their appointment times slowly creeped up over the years till it was 2 weeks for an appointment (how are you meant to get a med cert for work 2 weeks later??).
Switched to a private GP ~$30 a visit at the time, now closer to $50 and their wait times are creeping up. A lot of normal GPs are now charging above Medicare too.
Really falls apart when you need to see a specialist, 3-6 months wait on average (though in an emergency your doctor can call directly and negotiate a quicker appointment - never had that happen so no comment). Specialist fees start at a few hundred for the consult, or you wait on the public system for 1+ years.
Despite all that we do have some of the best hospitals in the world and in an emergency our costs are low-none. Our system ain’t perfect but it’s definitely not America
I think the Australian system is slowly getting worse. My sister got double jaw surgery and had to pay out of pocket (long story)...it cost her over $70k through the private system as the wait for the public system was 4 years!!
A few years ago when I was 23, I almost passed out on my way to work (probably just exhaustion). I was on the subway at the time and very spooked. Went to urgent care then a cardiologist, as referred. Ran on a treadmill for 5 minutes, received a $3000 bill a few months later as the test was “not medically necessary” despite me having a heart condition since birth. Spent the next 3 years fighting it until it disappeared.
FYI- Time based billing. The way billing works-this is not the actual face to face time with the patient. This time includes numerous other things before and after the visit. And yes it includes all the time we (health care provider) spend in your chart completing it in a timely fashion.
As far as recording visits. This is highly unlikely to be allowed. In the days of defensive medicine and continuous fear of law suits this would not be allowed. Anyone can be sued for anything!!!
Excellent video. Thanks for being brave enough to air it. The problem started with Nixon when Wall Street investors pressured him to remove the legal requirement that healthcare providers like hospitals and insurance companies be non-profit. Reagan further strengthened it by making private equity interests immune from lawsuits for malpractice. Healthcare and profits are a mutually exclusive conflict of interest because there is no incentive to reduce costs. In fact, they have every incentive to increase costs as much as possible. Why are our politicians doing nothing about this? Could there be a different kind of conflict of interest going on there? You figure it out.
Any kind of system where the majority of people feel helpless in is not democracy. Keep that in mind.
I appreciate this post, and this whole commentary series. As a Type 1 diabetic, I just want to clarify 1 thing. The cost of insulin was capped at $35 for seniors. Younger folks like myself would still have to pay crazy amounts. I am lucky that I have a full time job and medical insurance, or it would be $350/vial. A vial typically lasts me about 3 weeks. Also keep in mind that there are many different kinds of insulin, and they are not interchangeable. My doctor still has to argue with my insurance every time I need my insulin refilled, and type 1 diabetes is a life long illness.. it's not going away. The fact that someone sitting in a cubicle, in an office building, with no medical training gets to decide whether I need my insulin is a joke. Thank you for shedding light on this Insurance Scam Epidemic!
The simple truth is you pay much more in a private system than public because the point is to turn a profit. Though publicly funded privately delivered services are more expensive to the taxpayer, they at least have the check and balance that the government will refuse to pay for inflated service costs. The private insurance/delivery model in the US just seems set up for abuse.
Yes. Years ago I had purchased my diabetes medication for a little over $1,400 (a month supply). Then I had kidney stones and my doctor prescribed loritab (not sure how to spell, but pain meds). 150 tablets of a strong dose and it cost $9. . . $9 for addictive drugs since it must’ve been subsidized yet my diabetes drugs that I needed to live were 1,400
Also you should consider stopping going to the hot tub for a few months and see if that helps you. Hot tubs are notorious cesspools of infection especially pseudomonas and can often cause problems like these.
I woke up out my sleep with heart palpitations, went to the emergency room for 30 mins and they charged my insurance 30,000 😂
I think it’s crazy how adjustable the prices of healthcare costs are. I had a surgery and my copay was 8000. I said i literally couldn’t afford it and will go to a different surgeon. They eventually got it down to 1500 with just two emails.
We need more of this
$1500 is still way too much 😭
@@Zavlon yea i agree but this surgery was considered elective surgery for a lot of other insurance companies but my insurance covered it so i took it. It should have been free though and shouldn’t be an elective surgery for any insurance plan
USA is so crazy with how heathcare is done. Its always interesting to listen to these but it is really sad. Where I live I had chest x-ray, ultrasound, extensive blood tests, consultation with a doctor and a follow up phone call and i paid 46 euros. You deserve better over there.
There was a time when in the last century when doctors used to make house calls and people paid cash for their health care. They didn't need healthcare insurance or government run clinics. Healthcare was affordable and accessible before big government and big insurance firms took over?
In early 2000’s Our premiums were $80 a month. Prescriptions $0 and I paid $70 total out of pocket to have both my boys in the hospital with 2 days of stay private rooms. That was all in 2001-2006. It was so easy to get into a Dr the same week too. 20 years & everything’s changed.
99% of Americans never think or talk about this. They've been trained to accept all of this as normal.. .same witb gun control.
The American healthcare system is a huge scam. The people here are smart but they are being gaslight by the giant media like MSNBC and CNN to think that such horrible things like this is normal.
There are many more things in this country are scam too... The reason people don't see it is because they are too busy working or too tired.
The people are broken and upset because not just healthcare,,,, every things else is insanely expensive.
Excellent points. Now, imagine you have a debilitating chronic illness/injury and have extensive bills frequently. Not only do you not have time to deal with them, you don’t have energy, so you’re just screwed. 😕
Good for you Shelby for addressing this!
Something you’re missing with the costs of procedures is that those prices don’t reflect the true cost, not even in the US. There’s a variety of factors that influence those costs, one being lack of transparency and delays in reimbursement, but in the case of other countries, those costs are artificially low do to the government capping how much can be charged, at a rate not indicative of their market value. So while it may seem cheaper on paper, it’s actually below the point where costs can be recovered, which is why access to medical devices and pharmaceuticals is much lower in other countries compared to the US.
Because the US focuses on intervention, we excel in treating people when they’re sick, but fall short in keeping them healthy, whereas other countries fall short in treating people when they’re sick, but excel in keeping them healthy due to emphasis on prevention. Interventions require medical devices and drugs that cost a lot of money to develop and use and contribute to the high costs in the US greatly, but due to the probability of profit being higher in the US, most companies tend to develop them there and sell them there rather than in Europe.
There’s pros and cons to everything. If you have cancer, heart attacks or a stroke, your best bet for survival and recovery is in the US, if you want to be healthy and not have to deal with those things to begin with, your best bet is in Europe.
dude im a nurse and ive had no health insurance for six years off and on bc my float position doesnt offer it wven tho i work fulltime - figure that out. So everytime I get sick from work exposures I have to pay for it myself…the scams are everywhere its getting worse and its benefiting administrators and stockholders only not mds or rns. And the regulators are all invested in big pharma. My inhaler i need to breathe is $125 here and $15 in the philippines so i used to just buy it there. I also got diagnosed for PCOS there bc drs here wouldnt order an ultrasound!. Oh and the restriction on pain meds is ridiculous now i broke my arm and had a plate put in it nine months ago and i could only be given pain meds for three months i was still in therapy and everything…. oh yeah and where I live it takes six months sometimes for a primary appointment!!! I finally got health insurance on the marketplace again recently and i was working in a pulmonary clinic last fall and the pharm rep comes in and says “no one is going to cover symbicort next year” and walks off like they make these decisions based solely on profit not on patients…
To be clear your employment arrangement did not provide any employer provided healthcare insurance. You chose not to have health insurance.
No one pays for Shelby's health insurance other than Shelby. Shelby has chosen to have health insurance.
I just found out about “out of network” billings from an “in network” Hospital due to contractors. That should be illegal and considered a type of false advertising.
Health care is so expensive here in the United States
if you take out insurance and government the cost would be 1/10th.
if you stopped using big pharma medical and used a real medical system, the cost would be 1/50th.
@@brusso456
Aka fly to Tijuana
Get treated
Do dumb shit and get injured
Get treated
And fly back
All for less than the cost of getting treated in the US
Hey Shelby-unrelated- just curious did you end up using the DJI mic audio or the shure mic for the audio in this video? Thanks!
Many are bankrupted from going to the doctor and hospital.
I was just billed $2,400 for a 2 mile ambulance ride. My ER bill was cheaper than the ride.
I feel like ambulance fees are a scam, its usually like 3k for a 4 mile drive. Ive had to take one twice, once because a dog bite and another because a driver hit me and knocked me out while i was riding my bike.
Still waiting on the hospital bill.
Agreed...I took an ambulance for 6.5 miles, also after a bike accident. They charge a base fee, and then every mile ridden is an additional $65. I'm never getting in an ambulance again unless it's absolutely necessary.
Are you serious? A few thousands for a couple miles? This is crazy 💀
I went to the ER with a bit of chest pain. They said I’m either stressed or dehydrated or anxious, told me to bug ibuprofen, and I was charged with $75
ha! 3-4 days for a primary care apt?! hold my beer - first available appointment was 3 months away, and that was me being available any day of any week.
Loved this video, Shelby. 100% agree with how messed up this system is! As a nurse, I definitely see how it’s a systemic problem with how hospitals or healthcare in general is beyond overpriced that people are going into major medical debt. We see a lot of patients that have chronic or preventable conditions but they can’t manage their health because it’s not affordable to begin with. It makes me think about socioeconomic problems- how do people hold a job, keep their home, take care of their kids, and/or get an education if their health and medical debt are preventing them from progressing?
Shelby, thank you for making this video. You are on a roll and are so right in what you are doing!! Again thank you!
I lived in Poland and Switzerland and can confirm the waiting times are high only for very specific operations/procedures. In Poland you can wait and get something very expensive for free or go private, pay a bit and got it within days.
Yeah healthcare is a joke. I recently had to take my son to the E.R. He got a 1700 bill for glue. He had a serious gash on his chin and all he got for the 1775, to be exact, was GLUE!
It's medical glue so it isn't like the glue you have on your shelf but it still should never be that much.
My doctor told me the US is running out of GP's because the cost of med school is so high and insurance reimburses standard service so low that new doctors have to specialize so they can afford to pay off their loans.
Very interesting video! There's definitely a lot that needs to be talked about (and improved) about the health care system in the US!
As a high earner, your taxes would fund healthcare in a system like the UK's or Canada's. This is not necessarily good or bad--just something to consider. You might be better off financially under the current system, while a lower earner would be better off under a single-payer system. For example, in the UK about 20 % of a citizen's income tax goes toward funding the healthcare system. Someone who pays $5k in taxes would contribute $1,000 a year. Someone who pays $100k in taxes would contribute $20,000 year.
Hi Shelby, I am from the UK, and although the service is technically 'free', we pay for it big times in terms of our overall prosperity and opportunities. It totally sucks the life out of the UK economy, and is one of the main reasons the UK economy performs so terribly compared to the US. We pay for not just in terms of our incredibly high taxes, but also lower economic growth and lower wages. There is a reason why all the most successful companies originate from the US, and ultimately these are the businesses that pay for everything. The UK economy is strangled by the NHS and unless it is scaled back substantially will lead to indefinite economic stagnation or even outright decline in the UK. Is that worth free healthcare?
I notice Shelby isn’t replying to comments from those from other countries actually giving insight on those healthcare systems.
@@Market-pu2fzI notice you aren't noticing the context of that the RIGHT WING government in the UK has destroyed the NHS in the past decade. Specialists get paid 40-60% in Australia than in the UK. Not hard to determine it from there.
@davidpaterson7142 that's funny my aunt and friends live in the UK and they say barring a few niggles the health system is fantastic. It includes dental, optometrist and fertility treatments and more
@@tomjones2157 if that is the case it means that your aunt and friend are on either on benefits or very low earners. These are not free for the majority of working people in the UK.
Shelby, I've been anxiously waiting for this video to drop since you announced you were preparing it several weeks ago. I and many of your other followers think that your videos are actually a public service in addition to being a source of entertainment. Health care is one of those issues that effects everyone. Please keep up the good work!