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The Rotten State Of Health Care In The USA: Or How Can We Pay So Much & Get So Little?

CarolJoy, Not So Easy To Kill
@CarolJoy
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A few days ago, someone on social media recounted their experience at their local hospital emergency room.

The trip began when the individual realized they were feeling worse than lousy. He took out his home blood pressure device which confirmed that his blood pressure was through the roof. An ambulance came to their home and took the guy straight to the ER.

He was at the ER for a total of two hours. Numerous tests were done, and then, since his body had gone back to normal, he was sent home.

The next health crisis he experienced was when the bill for those two hours arrived. He was expected to pay out-of-pocket a total of $40,000. The charges consisted of those relating to several ER doctors in attendance, plus numerous tests.

He didn't make it clear how much the overall bill was, though he did refer to his health insurer as paying for some of the tab.

This seems like a lot to pay.

Then I read a series of posts over on X. The pediatric clinic that the post author usually takes her children to has developed a new policy.

What is the new policy? If the visit was made due to, for instance, lil Tiffany getting into poison ivy, hopefully Tiffany's mom doesn't bring up another matter. If she does, the bill will be twice the usual clinic visit cost, as two individual problems were discussed!

Then I stumbled into this discussion, also from X:

Wall Street Apes @WallStreetApes

18 hrs ago today
This is going to absolutely blow your mind.

Dr David Morris: “You want to know why something isn't covered by insurance that you think might help you or that your doctor thinks might help you? So I'm going to read you this, this is Medicare guidelines section 2251.3 --

I'm quoting this to you, "A treatment plan that seeks to prevent disease and enhance the quality of life or a therapy that is performed to maintain or prevent deterioration of a chronic disease is deemed not medically necessary."

READ THAT AGAIN

This is the state of healthcare in the United States. Prevention isn’t profitable so it’s "deemed not medically necessary"!!

#####

Sometimes words fail.

This post was promoted to the Main Feed at the recommendation of Ricochet's members.

Discussion (68)

  • Orange Gerald@Jose
    CarolJoy, Not So Easy To Kill (View Post):
    ...hopefully Tiffany’s mom doesn’t bring up another matter. If she does, the bill will be twice the usual clinic visit cost, as two individual problems were discussed!

    Yeah. My mom was warned not to mention any new issues at her semi-annual wellness check.

  • DonG (¡Afuera!)@DonG

    It all adds up to $5Trillion/year. Like most economic systems without a true competitive market, prices are too high. All that government involvement spoils the market. I do think that AI is going to make a huge difference. It is going to help with diagnostics and patient experience. I don't know if things will get cheaper, but they won't feel as cheap and rushed and impersonal.

  • CarolJoy, Not So Easy To Kill@CarolJoy
    ReplyingtoDonG (¡Afuera!)

    DonG (¡Afuera!) (View Comment):

    It all adds up to $5Trillion/year. Like most economic systems without a true competitive market, prices are too high. All that government involvement spoils the market. I do think that AI is going to make a huge difference. It is going to help with diagnostics and patient experience. I don’t know if things will get cheaper, but they won’t feel as cheap and rushed and impersonal.

    But AI will still have to abide by the MediCare guidelines of 2251.3, which reads:

    ‘A treatment plan that seeks to prevent disease and enhance the quality of life or a therapy that is performed to maintain or prevent deterioration of a chronic disease is deemed not medically necessary.’

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