this post was submitted on 13 Aug 2024
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Hey all, I'm British so I don't really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.

So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.

However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They're just some elaborate dance between insurance companies and hospitals. If you don't have insurance, the cost is lower or removed entirely. Supposedly.

So I'm just asking... How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.

How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?

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[–] [email protected] 34 points 2 months ago (2 children)

I work for one of the largest healthcare providers in the US. I pay $450/mo for health insurance. This is not including vision, dental, or money I set aside for FSA (a pre-tax savings account restricted for use for paying for healthcare) and for and HRA (similar to FSA, but intended for when you're older, and our company partially matches our contributions). The FSA has been refusing to pay for legitimate doctor visits that insurance has sanctioned. I pay out of pocket for a lot of procedures that the insurance ducks, such as laser eye surgery, vasectomy or even for birth control pills prior to the vasectomy.

The laser eye surgery was ~$5,000 out of pocket, the vasectomy was ~$2,000.

I had a visit to the ER - I was driven by my partner to avoid ambulance costs, and with insurance, had to pay $450 only for the doctors to stay they couldn't figure out what was wrong and I end back up there later that week for another $450.

I was in a car crash a few years ago and my medical costs (again, with insurance) came out to ~$250,000.

This is while making $85,000/yr working as a Senior IT Engineer, and paying $2,700/mo for rent.

Generally speaking, with insurance, we're probably paying about twice as much for any given situation, but insurance itself is also expensive and likes to dodge paying for as much as possible.

[–] [email protected] 8 points 2 months ago (1 children)

Thanks for the info! For a comparison I'll give you mine:

Switzerland has the worlds second most expensive healthcare system, also with private insurance providers. There are some differences to the US though. Having health insurance is mandatory and there are state contributions for people who couldn't afford it otherwise. And we have a certain defined level of base insurance with defined coverage that the insurers all have to offer and that you can't be denied for.

Anyway I pay $480/mo for mine, which has a few extras over the base, like sharing a room with only one instead of three people in a hospital stay. I haven't used it much though, so I can't tell you from experience what sort of co-pay I would be looking at, but I believe it's capped. https://www.bag.admin.ch/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherte-mit-wohnsitz-in-der-schweiz/praemien-kostenbeteiligung.html

This is while making $85,000/yr working as a Senior IT Engineer, and paying $2,700/mo for rent.

Oh shit, I thought IT people in the US made more than here in Switzerland?! Or is that only in specific areas of California?

I live on the outskirts of Zürich and rent for our 3 room flat is $3'200/mo. However, I started on about $100'000/yr as a Junior Network Engineer directly after completing my master's degree in Computer Science in 2021.

[–] [email protected] 0 points 2 months ago

What the heck? Hire me. Can I work remote from the US?

[–] [email protected] 2 points 2 months ago

I had a vasectomy this year, it came at a negative price for me as food and three days in hospital were covered.

That's what I said, but of course I paid a little for it out of my salary.