Feb. 16th, 2017

My tweets

Feb. 16th, 2017 12:00 pm
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When I had cancer in 2013 the doctor that I was referred to was the guy who ran the cancer unit at Hackensack and was considered one of the best in the region. He was out of network, but I figured I could afford the "out of pocket max" for that. My cancer was borderline "you're probably OK" to "you might have less than 30% chance of surviving 5 years" so I wanted a really good doctor just in case it was on the wrong side of that border. (In the end I got lucky; it was caught just in time, and I've been cancer free for 3.5 years now).

The total bill came to around $130k. However the insurance company declined to pay a large portion of it, claiming it wasn't covered. I loved getting a statement saying things like "You owe provider $31,995.40". It's just what you want when you're recovering from surgery and in pain.

Fortunately the doctor was willing to treat the bill as if it was covered so I "only" had to pay $8k on that (maxing out the out-of-network deductable), which meant the whole treatment for the cancer cost me $13k out of pocket.

Now I could afford that because I'm paid well. But I don't understand why someone less fortunate than me should have lesser care. I know a lot of people where this would have wiped them out and left them in years of debt. For cancer??! That's just bloody ludicrous.

(Also the dermatologist mis-billed and I punched the wall hard enough, in anger and frustration, to leave a dent; I should get that fixed. Yes, the whole American health insurance process doesn't actually work properly and having to deal with that shitty paperwork while recovering from surgery is also not ideal).

Now I've had to deal with the UK NHS (broken leg; total out of pocket cost zero). Around the same time as I had cancer, my Mum (back in the UK) needed back surgery working on nerves near the spine. She had it done on private (rather than on the NHS; same doctors, effectively just queue jumping) because my parents pay for this. The total out of pocket cost? 450 pounds, maybe $670 at the time. And that was for 2 nights in the hospital, compared to my out-patient surgery. She paid 5% what I paid for much more care and attention.

Obamacare was pretty much a disaster because it _wasn't_ healthcare reform; it was healthcare _insurance_ reform. It started from an awful place and only made incremental improvements (no lifetime max; can't deny for pre-existing conditions). We ended in an awful place, just slightly less awful.

I've dealt with the NHS, I've dealt with UK private health care, I've dealt with American healthcare.

The American system is "money keeps you healthy; fuck the rest of you". It needs burning down. But it ain't gonna happen because of attitudes in twitter, in newsgroups, in general are a microcosm of the greater (rich) American decision makers.

People ask "can the government do better than private insurance?" In this case they can't do worse and we have lots of evidence that it can be better. I see people point to NHS failures and say "see, government healthcare sucks", as if they're expecting a 100% perfect solution. That's retarded; every system will have bad edge cases. But compared to America the NHS is an order of magnitude better. (Shame the Tory's want to destroy it by underfunding it... *sigh* they're doing a good job, too!)

I pay a tonne of taxes for the local schools despite not having a kid. I pay roughly the same property taxes as my neighbour, despite them being a family of four (so make more demands on the city for things like garbage collection).

Why isn't healthcare treated the same way?

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