Looking into the future - Taxes

[macdaddy]

You can go to the hospital and get emergency treatment, but you will owe for the treatment. Try to negotiate rates when you are sick and wanting treatment now.

I know from personal experience that many (I would say most) doctors will cut a break for people who don't have insurance and who contact them and ask for help. So many doctors who work in the ER see patients who they know will never pay - who never even make an effort to pay - and who aren't grateful for the free care that they receive. So when one of them sees a patient who is grateful and would like to make an effort to pay something, it is usually a breath of fresh air. I have seen them slash anywhere from 20% to 80% of the bill and usually any kind of payment plan is fine. The bottom line is that for a bill under $1000 they aren't going to make much sending it to collections. (And there is always the fear that if they go after a patient with a collection agency, the patient will get pissed off and sue them for malpractice in retaliation - which would cost ~ 10k just to have dismissed from court.)

Most doctors make about $150/hour. Routine procedures are affordable for people. It's only when you start to have surgeries with multiple doctors and anesthesia or when you use the latest technologies for cutting edge stuff that it becomes very expensive. (Or when the hospital bills you $5k/night for a bed - although insurance usually only reimburses them about 30% of that and that's all you would have to pay also, but still pricey). Ironically, I think one way to bring down medical costs would be to have patients pay out of pocket for procedures and only have insurance cover serious illnesses and accidents.

 

[Martha]

Yeah, the doctors often are a small part of the overall bill. Hospital overhead is BIG.

I know someone who does collections for hospital bills for a living. Yes, they do still try to collect from those who don't pay. They will even garnish wages. Sometimes they settle and sometimes they don't.

It is not much of a solution to the health insurance problem to say that you might be able to cut a deal with your providers if you can't pay for your health care.

 

[bosco]

Marshac,

-- You need to use comparable populations or stop using numbers. Almost all the folks in Medicare are over 65, while the Canadian figures cover the entire population, young and old alike. I'm not surprised that medical care for people over 65 costs 3 times more than the population as a whole.

aside from the issue of the age of those covered, and adjusting numbers for population size, the simple fact is that procedures, drugs, and care are just plain cheaper in Canada. A hospital bed costs a fraction of what the same bed would cost in the US. I had to get a physical exam for my sons for immigration purposes (long story, but due to a hole in the law, they didn't derive Canadian citizenship from my Canadian birth). Looked at 3 designated practitioners in the US--approximate cost was $450 US per exam. The same exam in Canada cost $150 Canadian. This is typical.

This is, I think, a byproduct of having the government involved in the medical system. The downside of this is that doctors in Canada will often try to move to the US where they can raise their prices to whatever the market will bear, something they cannot do in Canada.