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America - its all a bit odd...

Really? Your earlier posts were interesting and I actually learnt something. Given how you were chopsing off about Brits criticising the US system without knowing the details, filling in the rest of them seems sensible.

People are entitled to emergency care. Is it free or do they get billed for it later? If you turn up without insurance, after emergency treatment are they thrown out of the door or do they get following treatment that the state pays for?
Here's a source a quick Google turned up:

Long story short, under US law you must buy medical insurance. If you don't, you get fined. Given that so many people apparently still don't have insurance, I gather that isn't effective.
If you choose not to have health insurance, you will face the fines imposed under the Affordable Care Act. These fines will be due when you file your taxes.

The fine for the 2017 tax year is 2.5% of your total household gross income. So, if you make $100,000 you'd pay a $2,500 fine. While the fine has not yet been announced for 2018, it's expected to increase.

Also, having insurance doesn't mean much on its own, as there are deductibles. At the lower end of the scale, you might have to pay $10,000 in deductibles out of your pocket before the insurance kicks in.

Once you get the bill, you need to pay it right away, as otherwise the hospital will send your case to a debt collection agency.
Once you receive a hospital bill, you should immediately call and set up a payment plan. Often the hospital will offer a lower payment amount if you can pay that amount in full immediately. If you have the money available, you should do this, otherwise you should set up a payment plan right away. Do not wait to call and talk about payment plans, because the hospital or doctor’s office may send you to a collection agency in as little as 90 days. It is more difficult to negotiate terms with a collection agency.

And once that happens, you are screwed.
Burying your head in the sand won’t make the bills go away. In fact, it could make the situation worse. Doctors and other medical providers will only collect on your account for a few months before they send the account to a collection agency.

At that point, the medical bill goes on your credit report and hurts your future chances of borrowing money, e.g. for a house. You can also be sued for the debt, which could result in a judgment, bank levy, or wage garnishment.

From other news that I have read, the people who end up in the worst situations aren't the rich (of course) or the poor. The rich have the money to pay whatever it costs. The poor don't have any assets which can be seized for debt, so they can walk away from bills.

The people with the biggest problems are the ones in the middle, who were doing alright, then medical tragedy strikes and they see everything they've worked for over a lifetime of effort being drained away to pay medical bills.

The thing that really strikes me about the American system is that patients are expected to know so much about the financial aspects of health care, including planning, negotiating, shopping for the best price, bankruptcy laws, how to deal with medical debt collectors, etc. None of these are anything someone is going to be in a position do once they find themselves in a hospital bed.

After many years of avoiding hospitals here (in Canada), I ended up in one very unexpectedly in the middle of the night. While I had things to worry about while there, none of those worries were about who was paying for it or whether I could afford it. It gave me a very, very, different perspective on things than I had before.
 
there is this new fangled concept called working online from where ever

And what makes you think I was referring to you as the one who doesn't attend work?

Yes I have heard and even done the working from wherever thingy. I don't believe you are though, hey ho you're the British taxpayers problem now :D
 
Here's a source a quick Google turned up:

From other news that I have read

Uh huh. Credibility established then.

Also, having insurance doesn't mean much on its own, as there are deductibles. At the lower end of the scale, you might have to pay $10,000 in deductibles out of your pocket before the insurance kicks in.

Bearing in mind that my current insurance is shit compared to the insurance I had before Nobamacare...

My current plan costs me $20 to go the family doctor. A specialist is $40. ER is $300. Urgent care is $50. Prescriptions are free/$10/$25/$50/$100, depending on the specific medicine.

For hospitalisation, the plan pays 80%, subject to an out of pocket max of $3K. So if I get in a horrific car wreck and spend 6 months in hospital with 15 surgeries, it costs me $3K. Maybe $3300 if they assess the $300 ER visit too.

Chicken Licken just needs to fcuk off.
 
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At least one of them attends work to earn a living.

Just call me Susie, I prefer the kitchen!
 
On another point, my family doctor's practice is part of the local teaching hospital. The University of Tennessee Knoxville Medical Center is the regional big cheese.
.....
And I live in a rural backwater. If you go to a bigger city, there will be several teaching hospitals.

Two things - Similar to you, my primary care (i.e. GP) doctor practices at a satellite office of Lahey Hospital with primary doctors, some specialists, labs, X-ray, MRI and Ultrasound. Two exits north on I95 is the main hospital, quite large, 1/3rd of a mile from the shiny new Trump Building to the equally new Emergency Dept. Most of the doctors are in the faculty of Tufts University, some are faculty at Harvard. Staffing is such that there is very little wait for needed services or tests. A few years ago I messed up my back and a leg got wobbly. The ER doctor ordered an MRI and 20 minutes later I was being shoved into the MRI. Eight years ago the urologist decided I might have bladder cancer. Two days later I was operated on and after 8 years am still here and cancer free. Speedy tests, imaging and treatment can be very important, especially for things like strokes and heart attacks.
The UK seems to have long waits for many treatments. In 2000 I had an incredible attack of pain at 40,000 feet 3 hours out from Heathrow. Ambulance to a nice hospital near Heathrow. Doctors were nice, mainly Asian, nurses were great, mainly Irish. The drugs (Diamorph, i.e. heroin) were lovely. Doctors wanted the keep me in a bed for the three weeks it would take to get me an ultrasound. I was traveling with my wife and son and we decided to continue on to Italy. I few weeks after we got home I had a repeat attack. I went to a major teaching hospital and the ER ordered an ultrasound. About 15 minutes later a doctor from radiology (not a tech) was doing the ultrasound and discovered I had gallstones and two days later my gallbladder was gone. Insurance covered everything.

There are huge advantages to having major teaching hospitals available, especially for mass casualty situations. I know the UK has suffered more terrorist incidents but in April of 2013 a couple of jihadist sorts bombed the finish line crowd at the Boston Marathon. Over 250 people had serious injuries and 29 patients had traumatic amputations, primarily legs. All survived. Three people died from the bombing but everyone who had a pulse when EMS got to them are alive today. A major factor was that fortuitously the bombing occurred one block from the marathon medical tent, filled with doctors and nurses. The bombing occurred roughly equidistant from seven major teaching hospitals * with trauma centers and were affiliated with three local medical schools (Harvard, Tufts and Boston University).
All this was aided by Boston EMS which had planned and trained for Mass Casualty Incidents. EMS had created caches of MCI supplies which were in trucks two blocks from the bombing. Captain Bob Haley of Boston EMS ran the MCI planning and training for years. He did an amazing job and the results were many saved lives. Bob was a friend of mine who suffered a stroke a couple of years and and died but not before he saw his son sworn in as a Boston EMS paramedic.

*Mass. General, Tufts Med Center, Boston Medical, Brigham and Women's, Beth Israel, NE Deaconess, Childrens hospitals (note: Children's specializes in children but in disasters does a fine job with anyone)
 
Oh dear lord, I know that. Now, if you could give an explanation of what happens after that point, feel free.

I think @LJONESY covered this but the costs of free care to those without insurance its picked up by increased costs to the insurance companies paying for those with insurance. All individuals over 65 get Medicare which is paid for by the feds. Medicare pays a portion and if you have insurance that pays the balance. For the poor with no insurance no problem, they get Medicaid paid part by feds, part by state government. This covers those who cannot or will not work. As a retiree I pay about $80 per months for insurance, my former employer pays the balance of the insurance.

I am lucky, I worked for 37 years for the same employer that always provided good insurance and continues to provide good insurance to retirees like myself. I pay nothing if I am a patient in a hospital. I would pay $50 for an ER visit unless I end up in a hospital bed in which case I pay nothing. Doctors appointments cost $15 each visit no matter what the cost. Checkups with my primary care cost me $15 and the insurance pays the balance including blood tests, urine tests etc. I go to a Neurologist-Opthamoligist very 3-4 months for injections in my right eyelid due to blinking spasms (tricky when driving). I pay $15 for the visit and she gets something like $1250 for the treatment. Certain procedures are free. Due to past bladder cancer surgery I have a cystoscope exam every 6 months (n.b.little tv camera up the penis into the bladder to look around). No payment required, insurance pays the whole thing. Colonoscope exam every 4 years, same deal, no payment (tv camera through anus into colon).

Prescriptions very by insurance plan, mine is typical. Prescriptions less than $10, I pay the full amount. Some prescriptions over $10, under $50, I pay $10 for a months supply. Higher price prescriptions I pay $25 for a months supply. One of the pills I take would cost $550 for a months supply but I pay $25

Hospitals suing patients is rarer than a rare thing. Most of the patients involved have so little in the way of assets that it would not pay to hire lawyers to file suit. If however the person with no insurance lives in a $4million dollar home with garage space for his Beemer and his wife Jag he might be sued. He deserves to be sued for being stupid enough or cheap enough to forego insurance.

Sorry I got a bit longwinded but I wanted to clarify how it works.
 
If you worked for one of tech giants like Google, Microsoft or Facebook or others...it's zero everything...they don't even charge a co-pay and everything is footed by the companies.
 
If you worked for one of tech giants like Google, Microsoft or Facebook or others...it's zero everything...they don't even charge a co-pay and everything is footed by the companies.

I have heard that about Apple too. My cousin works there and they have great day care for her daughter. When she travels they insist she leave three days early and relax where she is going as they don't want her jet lagged at meeting where she is representing Apple. She stays in France eating French food and drinking French wine, a tough life. She and her wife live in San Francisco and Apple has free shuttle busses from SF to Apple HQ.
 
I have heard that about Apple too. My cousin works there and they have great day care for her daughter. When she travels they insist she leave three days early and relax where she is going as they don't want her jet lagged at meeting where she is representing Apple. She stays in France eating French food and drinking French wine, a tough life. She and her wife live in San Francisco and Apple has free shuttle busses from SF to Apple HQ.

Apple is one of the more tight lipped ones though...compared to the others. But in general they all have a zillion perks, trying to out to do each other. The goal being to keep you on the "campus" for as long as possible...everything from free food at all times to childcare to laundry....and most importantly pay. Though a six figure + sum doesn't go far in the bay area, you still have to share a place with other flatties.
 
Apple is one of the more tight lipped ones though...compared to the others. But in general they all have a zillion perks, trying to out to do each other. The goal being to keep you on the "campus" for as long as possible...everything from free food at all times to childcare to laundry....and most importantly pay. Though a six figure + sum doesn't go far in the bay area, you still have to share a place with other flatties.

The money the younger generation get now is amazing. I suspect my son, in his 30's, makes more than I did when I retired. I know my cousin with Apple bought a home in SanFrancisco two years ago.

Then again the young man from across the street from me had to relocate at 23 to Minnesota but apparently gets $1.9mil per year for the next two years. Really nice young man and I am happy for him.
 

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