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this post was submitted on 30 Dec 2023
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For us non-US readers; what's the difference between health insurance and healthcare? For comparison, in Australia private health gives you a room, nice TV, edible food etc but you don't get priority. When it comes to essential surgery or treatment you join the line with everyone else.
Emergency rooms are required to try and stabilize patients before they discharge them. These patients are billed after they leave the hospital, insured or not.
If I try to schedule a checkup or procedure, I need to give my insurance card first. Uninsured can pay for a flat fee upfront. If they can't pay, they get no service.
With insurance, things get complicated. The facility will try to give you an estimated cost of the service. But it's always a back and forth with 2 or 3 parties; the insurance, facility, and doctor network. If there is a disagreement between parties, you the patient get a bigger bill. Even when you payed for the procedure beforehand.
It's even more fun when, for example, a scan is covered but the person reading the results is not. Or a surgeon and surgery is covered, but the anesthesiologist is not. Or your usual ob/gyn isn't working when you go into labor at 2am on a Sunday.
Yea, I fucking hate bill balancing. We received a $10,000 bill for a neonatal consult a day after my son was born. He had a little fluid in his lungs, was gone in an hour or two.
The doctor was part of the hospital system but I guess that 2 miles he drove to the women's center justifies a $10k bill. Our healthcare is broken.
It's complicated and shitty, but people are treated the same for the most part, there's no "fast pass" for having better insurance. Hospital and doctors offices are private. You can have private health issues, or if you qualify because you are poor or disabled you can get free health insurance from some states which then pays the hospital or doctor for your care. If you have your own private health insurance through a work group plan or you pay for yourself then you might have to pay a percentage of the total cost called a "copay" or you might have to pay the total cost until you have paid a yearly deductible and then you will only pay a percentage of the total cost until you reach an "out of pocket maximum" for the year which can range from a few thousand to ten thousand or more dollars.
Health insurance implies a middleman that is profit driven to get as much money as possible by denying fringe claims, healthcare is paid for by all and has your health as its driving force.