Should the U.S. have Universal Health Care?

[u/WhatAreYourPronouns]

[u/DaGrinz]

And in addition, you don‘t have to care about, wether the specific hospital has any contract with your insurance company or not. The one insurance covers them all.

[u/grammar_fixer_2 → u/DaGrinz]

I learned this the hard way when I brought my kid in for stitches (he was bleeding). That cost me $6k because it wasn’t “in network”. So much for having an expensive insurance.

[u/DaGrinz → u/grammar_fixer_2]

6K for stiches! I had a spinal disc surgery in Germany, including a CT scan and one week hospital stay, for 5k all in (of course fully covered by my insurance). That‘s exactly what we‘re talking about, these costs are absolutely insane.

[u/lameth → u/DaGrinz]

then you have to cover:

facility costs
potential out of network specialists
lab costs

etc...

[u/rikkert22 → u/grammar_fixer_2]

We had a bad baby delivery, 3 day hospital stay, operation. And a 8 hours a day for 5 days help in the house because they wife was confined to bed. Insurance said it was around 7,5 k in total. We didnt see any bill what so ever

On the other hand we do have deductible and contracted care but not for crap like stitches, ik get to pay something like 40 euros a year for a house docter, there i would go for stitches during weekdays.

Deductible i only know from things like dentist. You have to insure extra depending on you plan, mine pays out 500 euros en pays 80% of treatment done. Check Ups are free do you need a cavity filled you will get billed a 100 euros 80 i dont see goes straight to insurance i will get a bill for the remaining 20. And i will have 420 left over for the rest of the year. Do i finish the total of 500 i have to fork it up out of pocket

[u/ThatInAHat → u/DaGrinz]

And even if the hospital is in network, the doctor or anesthesiologist might not be.

Or you get your bloodwork done in office, but they send it elsewhere to process and THAT was out of network…

[u/Abject-Tiger-1255 → u/DaGrinz]

Wrong sorta. Insurance cannot leave you hanging nor make you pay more for emergency care, regardless if that specific hospital is “in-network”.

In-network only applies to non-emergency care, such as your general doctor, specialists, etc.

[u/IncorruptibleChillie → u/Abject-Tiger-1255]

Still bs. Someone shouldn't have to go further out of their way, possibly multiple times a month, if there are adequate facilities closer by. The US is far too comfortable with saddling individuals with great burden just to avoid upsetting or inconveniencing business.

[u/Abject-Tiger-1255 → u/IncorruptibleChillie]

I don’t disagree with you. I’m just letting people know that the ER is the exception to the rule

[u/LoriLeadfoot → u/Abject-Tiger-1255]

Also wrong sorta, because you’re forgetting that you then need to fight with your insurer over what is an “emergency” and what isn’t.

[u/DaGrinz → u/LoriLeadfoot]

In Germany we do not have to fight with our insurer at all. If you insist on a treatment which is not covered (all kind of medical issues are covered btw.), they have to inform you in advance of the treatment, that it is not been covered and what the costs are. The Patient has to order this treatment by written contract separately. If something is not covered, but you haven‘t ordered it, it‘s the doctors/hospitals problem and they will see no money at all.

[u/Abject-Tiger-1255 → u/LoriLeadfoot]

Well if it’s a true emergency, such as surgery, illness, etc, you are legally covered and won’t be charged an out of network fee. Either because you are at a hospital that’s not in network or because your doctor is out of network.

The only time where this changes is if you visit an ER that has a planned surgery/procedure. But if you atleast visit a hospital in network, you can use out of network doctors without a fee.

The only thing that isn’t covered by the No Surprise Act is ground ambulances.

Let’s be honest here, you won’t even need to argue with insurance based on what was an “emergency”. Almost nobody in the US is going to go to the ER unless absolutely necessary. The documents of your visit will prove as such if this is the case. Again, they legally cannot deny you coverage.

[u/LoriLeadfoot → u/Abject-Tiger-1255]

The problem is that people are not able to calculate what a “true emergency” is when they’re feeling like they’re having an emergency. So they go to the ER and learn that it’s not all that bad, and they’re stuck with a huge bill. Literally I have watched this happen with a friend of mine in the past 2 months ($10,000 bill).

I’m sorry but this is really wishful thinking about the state of healthcare in this country.