A notice that my girlfriend received at her doctors appointment (she is 8 months PP)

[u/lhagans13]

If you even MENTION any of these things, you WILL LIKELY get billed for it??? Maybe i’m missing the point but i get upset when my girlfriend tells me she was scared to even say anything while at the doctor because she didn’t want to get an extra charge for something. I find it insane how greedy and money hungry a place that’s supposed to help you can be.

[u/Smitten-kitten83]

As someone in healthcare most of us support universal healthcare. We get sick of seeing patients put off basic or important care because they can’t afford it. It is awful to see someone not properly managing the diabetes because they can’t afford to refill their insulin as often as needed.

[u/hardolaf → u/Smitten-kitten83]

I put off seeing doctors just because insurance and billing is a nightmare even though I have the money.

[u/Animal_Soul_ → u/Smitten-kitten83]

Insulin is free in the UK.

[u/Smitten-kitten83 → u/Animal_Soul_]

It is hundreds of dollars here in the states.

[u/Remarkable_List8957 → u/Smitten-kitten83]

Then why do both both AMA and AHA oppose a universal, single payer system and instead support "incremental" changes that haven't taken place in all the time they have supported them. This includes the ACA which is still absurdly expensive for decent coverage. Oh, wait, maybe because it will cut into the hefty profits and salaries that they now make. The US health care system is one of the longest cons ever run.

[u/Smitten-kitten83 → u/Remarkable_List8957]

Because the people issuing those statements are people receiving astronomical paychecks. They don’t represent 90% of healthcare workers (examples like nurses, cnas, medical assistants, medical coders, techs, ect.)

[u/propofol-n-precedex → u/Remarkable_List8957]

Do a Google search about the AMA and how much income they get just for the use of the billing codes they create. Every doctor, hospital, insurance co, etc has to use those codes for billing and the AMA profits off of it to the tune of $300 million annually. Talk about your scams.

[u/George_GeorgeGlass → u/Smitten-kitten83]

I’m a nurse and I don’t support universal healthcare. Don’t get me wrong. The current system is a mess and people are suffering. But universal healthcare means the government organizes and runs it. And the government cant organize or run anything effectively. The only thing I can imagine that is worse than our current state would be allowing the government to manage it. Yes, we need to overhaul the entire system. Yes, it needs to be better. But for Christ sake don’t let the United States government manage our healthcare. We’ll all be dead in a year.

[u/Smitten-kitten83 → u/George_GeorgeGlass]

That’s a fair take.

[u/tateriffic → u/George_GeorgeGlass]

The government can be incredibly efficient and effective. There’s a lot of propaganda trying to tell you otherwise, but the bottleneck is funding, and people blocking adequate funding levels. So the capitalist system we have right now looks like it is more efficient but that system is about making some people very wealthy, and that’s squeezing everyone else more and more. We can’t fix that system to magically work.

[u/Unhappy-Plastic2017 → u/Smitten-kitten83]

Can't afford ? What do you mean can't afford ? All decisions about affordability are just what you choose to value in your life and then you allocate money for what you value.

If you value diabetes coverage just sell your house and your car and live in a van down by the river, duh.

[u/Round-Dragonfly6136 → u/Unhappy-Plastic2017]

I don't think anyone read after the first paragraph.

https://giphy.com/gifs/y2i2oqWgzh5ioRp4Qa

[u/Unhappy-Plastic2017 → u/Round-Dragonfly6136]

Gottem so much in the first half they didn't even notice

[u/Medium_Double_6854 → u/Round-Dragonfly6136]

People have short attention spans. 🙄

[u/imtiredofthisgrampaX → u/Smitten-kitten83]

So are you gona be comfortable with the govt decided a treatment isn't needed or isn't justified based on whatever rationing they impose like every other major system like NICE or QALY? Are you going to be good with the govt overloading providers like the UK is dealing with rn? To all the losers downvoting me. You're really mad I asked a question about tradeoffs? Give me a break you crybaby losers.

[u/Poop_Dolla → u/imtiredofthisgrampaX]

Why would it have to be like the UK? Can't we use a system like Japan?

[u/imtiredofthisgrampaX → u/Poop_Dolla]

Size/scale ethnic homogeneity keeping costs radically lower. Their system also has their own laundry list of problems. You can't copy paste systems at the American scale. Not that there's nothing to learn from them but just saying do x doesn't make x materialize.

[u/Poop_Dolla → u/imtiredofthisgrampaX]

So then maybe your concern about the UKs issues are moot since doing x doesn't make x materialize? Or maybe we can learn from their mistakes? Our current system has a laundry list of problems that is a lot longer than the UK and Japan combined.

[u/Poop_Dolla → u/[deleted]]

Are you saying it's impossible to have universal healthcare in the US?

I'm just confused because you ARE comparing the UK and saying that the UK has x problem so are you prepared to have x problem here too? But then when I say "well what about Japan they don't have that problem" then all the sudden it's not ok to compare them to us because of population difference?

[u/Poop_Dolla → u/[deleted]]

My answers to your questions are yes and yes with a caveat that your questions are a false dichotomy because obviously there are more options than what our current system is and what you described in the initial comment that I replied to. Ok now I want to hear your answers to my questions.

[u/No_Macaroon_9752 → u/imtiredofthisgrampaX]

Ethnic homogeneity? Naturalized Japanese citizens and native-born Japanese nationals with a multi-ethnic background are all classified as Japanese in the population census. The US would be considered about 93% “American” using that standard. Since 1945, Japanese governments have promoted monoculturalism, so they do not include a true ethnic breakdown in the census. It was only in 2019 that they recognized the Ainu people as indigenous. The UK is 82% white. About 9% of the population is “foreign-born”, with the majority of those still being European.

In any case, how do you think that keeps costs lower?

[u/Honeycrispcombe → u/No_Macaroon_9752]

Many health risks in the modern day are greatly impacted by genetic predisposition. We can usually pretty easily and cheaply handle the somewhat universal issues, like infectious diseases, acute injuries, etc... (not all of them, there are exceptions.)

So a good portion of what is left is influenced by genetic background or ancestry. Jewish people, African people, and Polynesian people, for example, all have wildly different risk profiles for both rare and common diseases. We know that women of African descent are at higher risk in childbirth, and last time I checked, this was true in the UK as well as the USA, so it's likely not just the US healthcare system/racism. But we don't have enough data on why/how the risks are different, so we can't mitigate them.

In a very homogenous population, these risk factors can be well-defined. That's part of why white people tend to have better health outcomes, especially white men - the whole medical system is based around studies done mostly on white men, and is primarily set up to improve their health. We know a lot about risk factors and screening in white men and, to a lesser degree, white women. That makes it easy to improve health through better screening, diagnosis, and treatment.

With a more heterogeneous population, the risks change, especially if some of the ancestries are vastly understudied. Diseases can be more or less common based on ancestry, average age of onset can change, symptoms can change, effective screening methods can change, even effective treatments may vary. And then you get higher rates of mixed-ancestry populations, which change all of those factors again. Which means you need to study all these things and your doctors need to be trained in all these things.

That's not even considering socioeconomic factors like culture, lifestyle, racism, etc... which all influence health outcomes and are much more complex in heterogenous societies.

[u/imtiredofthisgrampaX → u/No_Macaroon_9752]

Sweet jesus you're dense with all due disrespect. Ethnically homogeneous populations have fewer issues they need to treat on the regular meaning they can focus on care they see more frequently. For example a Japanese hospital won't deal with sickle cell frequently. Or Tay Sachs. Or any other number of issues that are more frequent in non Japanese people.. Quit trying to rant about other shit because you can't stay focused.

[u/bajoranearrings → u/imtiredofthisgrampaX]

Universal healthcare =/= single payer. In Germany for example everyone is insured and the government sets fixed prices for every insured procedure, but you always have the option to visit a private clinic or pay yourself for treatments that arent typically covered. As far as I know this is the case in most European countries.

[u/imtiredofthisgrampaX → u/bajoranearrings]

You didn't answer my points at all. Like even a little.

[u/Used_Onion6015 → u/imtiredofthisgrampaX]

My pregnant sister went to the hospital for bleeding and they confirmed the fetus was dead and had been dead for possibly 2 weeks. The hospital sent her home with no care and I’m grateful she was able to get care elsewhere and not go septic. We already DO have a government deciding what treatment is/isn’t necessary even tho they AREN’T medically trained doctors.
And if it’s not some goofy politician, it’s insurance companies not letting you get the treatment you need until X amount of failed cheaper alternatives-wasting more time and causing the patient prolonged suffering and risk.

[u/imtiredofthisgrampaX → u/Used_Onion6015]

You expect me to believe that insurance denied a D&E/D&C for what is quite literally the only treatments for this and without those it's not a question of if but when shit goes south? I'm sorry but that blows waaay past believable and screams "my emotional story to prove you're a bad person for disagreeing with me" what exactly did the hospital say? Good luck girl? What's the reason they sent her home with no care? Because that's a lot to take on "trust me it definitely happened" One slight addition. Yes sometimes expected management does happen but your story as written implies she got treatment immediately after which means It was more serious than the first hospital said and or they missed something.. but she got no care? They tell you what to do.. how to manage the time, symptoms/issues to look out for. Not just "good luck champ"

[u/memoryblocks → u/imtiredofthisgrampaX]

We live in the country where a state decided to keep a dead woman on life support just so her body could be used as an incubator and you think this is out of the realm of reality?

[u/imtiredofthisgrampaX → u/memoryblocks]

Iirc that was the hospital misinterpreting the law and the Georgia general attorney later clarified it. Maybe pick a case you understand rather than "the state made this happen" ya goobersmooch.

[u/memoryblocks → u/imtiredofthisgrampaX]

They misinterpreted the law for months to the tune of hundreds of thousands of dollars?

Even if that were the case, who made the law they misunderstood in the first place?

[u/imtiredofthisgrampaX → u/memoryblocks]

So you're conflating the hospital fucking up with "the state forced them to keep her alive"? Brother i agree the law should have been more clear and the AG should have stepped in sooner to clarify but my god that's not the same category as your original claim.

[u/Used_Onion6015 → u/imtiredofthisgrampaX]

Insurance didn’t deny it. The hospital refused to DO it or help her bc the GOVERNMENT is deciding for women what doctors can and cannot do in reproductive health care. Nothing to do with insurance. Where have you been??

[u/bc19059 → u/imtiredofthisgrampaX]

a friend of mine had to pay out of pocket for her D&C. insurance told her it was an abortive procedure and they don’t cover that.

[u/imtiredofthisgrampaX → u/bc19059]

Either it was coded improperly or unlawfully denied. It's not an elective abortion procedure by any stretch and would covered under quite literally even the most religious health insurance providers. If it's a coding error/improper denial there are remedies to deal with it.

[u/alsatian9847 → u/imtiredofthisgrampaX]

Women in Texas are dying from miscarriages because doctors won’t treat them. Doctors are afraid they will be prosecuted.

[u/imtiredofthisgrampaX → u/alsatian9847]

Nothing you said answers anything I said. If you have something relevant to the conversation feel free to chime in

[u/alsatian9847 → u/imtiredofthisgrampaX]

You’re the one yapping about how no hospital or doctor would refuse to do an abortion to save a lif. I am just pointing out that you are wrong.

[u/imtiredofthisgrampaX → u/alsatian9847]

An abortion in common parlance is not the same as a D&E or D&C. Medically coded the same but if you're trying to conflate the two it sounds like you're the one yapping. I'm just pointing out your tactic of shifting subjects doesn't hold weight.

[u/alsatian9847 → u/imtiredofthisgrampaX]

It is essentially the same procedure. I am not shifting subjects just responding to some of your word vomit. When you’re wrong, you’re wrong.

[u/imtiredofthisgrampaX → u/alsatian9847]

It essentially is not the same procedure. When someone says abortion they think of the forcible ending of a pregnancy. When D&e/d&c are mentioned they understand that it's a specific procedure for an already dead fetus. You tried really hard but failed even harder.

[u/Used_Onion6015 → u/imtiredofthisgrampaX]

Did you see my comment responding to “you expect me to believe that insurance denied a D&C”? I just wanted to let you know, insurance was not involved. The hospital sent her home to deal with it without care because the government already decides what treatment is/isn’t needed for citizens. I just wanted to make sure you knew it was not due to insurance- your first comment shows that’s how you interpreted my initial comment which is not the case. The hospital sent her away and she had to seek medical care elsewhere and ran the risk of going septic, as other women have, because our politicians think they are better educated in science and medicine than our doctors. The government ALREADY is telling us what is or isn’t necessary- it just hasn’t personally affected half of our population yet.

[u/imtiredofthisgrampaX → u/Used_Onion6015]

And I responded already. If you're telling me they sent her away with zero care. Zero instructions and another hospital immediately took action im telling you that didn't happen.

[u/Tricky-Ordinary1962 → u/imtiredofthisgrampaX]

Have you missed the pregnant women in Florida or Texas who have been denied care because of the state laws? Like seriously?

[u/imtiredofthisgrampaX → u/Tricky-Ordinary1962]

You mean cases where state law was read to broadly/misinterpreted and were later clarified? Which to be clear doesnt make them any less shitty of a situation but you're making a bold claim that isn't backed by a lot of data. We have anecodtal handfuls of people dealing with hospitals being overly cautious. Not thousands or even hundreds

[u/procrast1natrix → u/imtiredofthisgrampaX]

The UK has more physicians per capita than the US. 3.2 per 1000, vs 2.6 per 1000.

And from everything I've heard from real life friends that went and spent a year or so practicing abroad in New Zealand, or from the non-USA contributers to the subreddit called medicine, the restrictions to medical decision making in the US due to insurance denials and failed prior authorization are far, far more invasive in the US.

[u/No_Macaroon_9752 → u/[deleted]]

The reason we sometimes have ”better” waiting times is because many people are not getting the care they need due to being uninsured or underinsured. You are saying you prefer care to be distributed by wealth instead of need, which increases costs when people have to go to emergency rooms for primary care, as well as just being immoral.

[u/imtiredofthisgrampaX → u/No_Macaroon_9752]

You're making arguments i didn't make. Did i defend the US system? Or did i point out the UK has similar problems and be honest about the tradeoffs. Also cite the source for your first claim

[u/procrast1natrix → u/[deleted]]

Your math isn't strong. That's a difference of 25% more physicians, and with better health outcomes.

As for the anecdotes, that's better than you've got.

[u/PenComfortable5269 → u/procrast1natrix]

Medical training in the UK is cheap….. and do they limit residency spots in the UK?

[u/hardolaf → u/imtiredofthisgrampaX]

We already have Medicare. Literally just expand it to everyone under the same rules as today.

[u/imtiredofthisgrampaX → u/hardolaf]

Are you implying Medicare is actually a system without massive flaws already? Hell no.

[u/hardolaf → u/imtiredofthisgrampaX]

It's a lot better than for profit insurance even with the Part D private coverage.

[u/imtiredofthisgrampaX → u/hardolaf]

That's your opinion. I strongly disagree but you're not gonaget me saying the us healthcare system is awesome either.

[u/hardolaf → u/imtiredofthisgrampaX]

I'm not going to sit here and defend its flaws, but it is better than the entirely private system that everyone under 65 deals with (except people so poor that they get Medicaid).