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this post was submitted on 03 Apr 2026
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The doctor's office when they're an hour behind because people keep coming in late.
I've had appointments at opening time and they're still half an hour late. Doctor strolling in 15 minutes after the appointment time.
That'll be $47,000
As a Canadian I genuinely can’t tell if this is an exaggeration or not.
Depends on about a billion of different factors, but the answer could range from "yeah it's an exaggeration" to "its actually a pretty generous estimate"
I have a "fun" american anecdote for you then! The office that gave me crap for being late a while back is also coincidentally the expensive one.
I'm on a biologic medication that I get every month via IV. I get the infusions at a cancer treatment center at the local hospital. The chairs are comfy and the nurses are amazing. They will actually give me free snacks and drinks too. I am typically there for about two hours.
The amount they charge my insurance company? About a new BMW.
What my insurance company actually pays them? Surprisingly, about a new Honda!
Did you have to pay the difference out of pocket? Or is there a discounted price for insurance providers to pay that laypeople aren’t approved for?
Whenever I go to the doctor, hospital, etc I just give them my health card (which is freely provided to every Canadian citizen) and they punch in the number into their system, then that’s that. I don’t have to pay or contact insurance or anything. Some stuff doesn’t count such as the dentist but dental care is almost always provided through work benefits.
Oh boy, I get to do more Freedumsplaining!
The luxury sport sedan price is the fake sticker price they bill up front.
The sensible commuter sedan price is the secret agreed-upon price that the insurance actually pays out to them.
The out of pocket costs are a completely separate number, where the individual is responsible for all the costs until they hit their deductible (and sometimes pay a percentage for a while until they hit a second complete out of pocket limit).
For some of us, however, there is a silver lining to this shitcloud. Obviously when a 2-hour stint in a chair gets paid out actually for real at tens of thousands of dollars, that money is not going to the wonderful nurses poking my arm and checking on me. Therefore, it is very much in the best interests of the pharmaceutical shareholders that I do not stop my treatment just because I can't afford it. So these companies have copay assistance programs that will pay your out of pocket costs, with no income threshold.
So the reward that I get for having a health condition is... I effectively get decent healthcare coverage as an American. For 11 months of the year. If something bad happens in early january it can cost a few grand in the blink of an eye.
You can't be on government insurance and use those programs though. But Medicaid on its own is great coverage.
That system seems so alien to me, I can’t even imagine. When my wife gave birth, she lost a ton of blood, like, far more than normal. She ended up needing both an iron and blood transfusion, and we needed to stay for a few extra days. She got a ton of meds and got seen by several doctors. Plus my baby had a couple small issues too which needed to get treated. Everything worked out okay, and everyone’s healthy now, thankfully. We didn’t pay a single cent. It was all covered. I can’t imagine making those decisions thinking about how much it would cost. I remember shortly after birth we were looking at how much birth costs in the States, it was insane. I can’t remember how much now but it was just for regular birth, I’m sure all the extras we needed would’ve cost more.
At least I don't have to put up with that part with the NHS
Oh, you see an actual doctor? I haven't seen an actual doctor in the last like 3 years, always just a physicians assistant or other nurse.
Still get charged the dr copay though, funny how that works.
I wouldnt be surprised if the doctor is an AI construct and theyre just running my symptoms through whatever insurance company provided AI bullshit at this point.
Tbf, there is no "doctor copay." The copay is a visit fee imposed by your insurance company that disincentivizes people from visiting the doctor. It's also usually a paltry amount compared to the actual amount your insurance will pay the practice, and reimbursement fees for NPs and PAs are absolutely lower than for MDs
My bills literally list them as separate line items, theres the clinic copay, then the doctor copay.
Occasionally I even get two separate bills, one from the hospital, one from the Dr. Guessing their practice is the source of the one and the hospital system is the other?
Either way its fuckin annoying to be paying out of pocket 30+ bucks only to be told the equivalent of "gee i dunno take Tylenol I guess".
I've worked in healthcare for decades and have literally never seen this. Are you sure you're not thinking of coinsurance? Coinsurance and copays are two different things, a copay is a set fee dictated by your insurance that you pay up front, whereas coinsurance is usually the percentage you owe of anything billed to your insurance, which includes both facility and provider fees
I'd have to look at my bill(s) but long story short, every time I visit the doctor, I get billed by two seemingly separate entities for merely visiting them. Everything else they do is a separate line item on their respective bills. So if it's not a copay, what is it? A visit fee? All I know is I either pay it or I get harassed incessantly so I pay it.
A copay is what you pay up front at the doctor's office. Depending on the services provided, you may receive a bill after the fact that will be either the percentage you're obligated to pay by your insurance company (coinsurance) or the balance your insurance didn't cover, for example if you haven't met your deductible. You'll definitely sometimes get separate bills from a provider and a facility, but usually at hospitals moreso than outpatient clinics
My mum is a nurse. From what she tells me, almost all wait times are caused by the doctors who book too many patients and appoint each patient too little of time.
I love how multiple people itt are defending doctors making us wait up to an hour after our appointment time as if it's not 90% their fault
TBF it's usually not the doctor's fault, it's systemic.
Systemic as in "everyone else does this so we have to in order to compete"?
It's always seemed to me the issue is over scheduling
So, doctors should see fewer patients? Meaning it would take longer to get the appointment in the first place, but at least you wouldn't have to sit in the waiting room for a bit?
How many people skip a visit to the doctor because of the waiting time?
Honestly it does deter me a little.
They should schedule realistically and not make people wait over an hour as has happened to me several times. Are you really suggesting that doctors offices don't fuck this up royally? It's not on me to tell them how to fix their business but it's abundantly obvious in America that doctors can do whatever they want to you and they don't care if they waste (a lot of) your time. Nothing about that is inevitable, at least not nearly to the degree that it happens
Exactly. If it's at a hospital, then the doctor has little to no say in the matter. I will always blame the bosses before the workers.
In America I have rarely gone to a hospital to see a doctor. Most of my doctor visits have been to practices with 3-5 doctors. They could choose differently. what I notice is that doctors are rich and all seem to live in very nice homes and drive fancy cars. They over schedule and waste our time because they want to maximize their profits. Not because they have to. Healthcare in America is about making money and it sucks.
I hear what you're saying. But these are hard working people who suffered through a residency and have no personal lives. It feels like we're being crabs in a bucket.
Three overwhelming majority of that profit is going to insurance and pharma shareholders, not to the doctors themselves. The difference between a doctor and a billionaire is about a billion dollars. Everybody ought to be living like doctors and it's the shareholder's fault that we aren't.
It's taken decades of bad experiences for me to get here. I have seen time and again that most doctors are not interested in helping people. They are interested in driving a Mercedes and retiring with millions of dollars. They aren't billionaires but they are selfish pricks. And you can easily tell the difference between the minority of doctors who do care and the majority who don't. The typical doctor assaults you with "you're just another patient" vibes from the first moment you walk in the door. They don't ask followup questions, they don't listen to your complaints about whatever issue you're having, they're basically worse than a Google search.
Then sometimes you're faced with insane billing issues like one I'm going through now from a mental health professional who came back months later after not helping me at all and being completely inept at their job to try and double bill me for all the services I already paid for. This guy sucked from day one, utterly incapable of communicating, and now he's repeatedly blown me off when I try to straighten this out and prove I paid it. I approached him for help with stress and anxiety and literally got no help and added stress and anxiety about the fucking basics of just trying to seek help from him. I honestly suspect he's a scammer who has pulled this double bill scam a lot. I know this area has a lot of wealthy people who would've assumed they made a mistake and just paid the bill of hundreds of dollars again. I could tell you several fucked up stories about how doctors wasted my time, not helping me at all, costing me a lot of money, and stressing me out.
Trust me, I've appreciated the great doctors I've seen. They are wonderful humans who clearly want to help people. It's unmistakable and unforgettable when you get a doctor like that. I have no beef with them, and even if they made me wait a long time, I'd assume it wasn't their fault. But I'd guess out of the doctors I've seen in my life, and we're probably looking at 30-50 doctors at this point, less than 20% actually seem in the field for good reasons.
And just for clarity, I'm in the US. It's likely that percentage is much higher in civilized countries.