Only in America, the world's greatest country...

For the record and to be accurate this is how Australian universal health care operates. All taxpayers contribute a share of their hard earned to the Australian Tax Office (ATO) who in turn pass this money on to the Australian (Federal) Government, which uses these funds to fund a range of government outgoings including health care, education, roads & train lines as well as defense.
There are five main sources for health care funds, they are the Australian Government, State & Territory Governments, Private Health Insurance, Individuals (patients) and Workers’ Compensation and other insurers.

There are limits to what healthcare is provided to patients, without any further payment being required by the treatment provider, these include public hospitals, ‘bulk billed’ services such as GP’s pathology and optometry. People who hold Veterans Gold Cards, Health care cards, pensioners and children under 16 years of age can also access medical services without any further payment.

While this may appear to be a good healthcare delivery system it often fails to deliver due to budget constraints each state or territory oversees the healthcare in its jurisdiction, and bears that responsibility. In WA successive governments over the last three decades have promised to ‘fix’ the healthcare issue, they never do.

Other states have similar issues, at various times such as winter flu outbreaks ambulances may be ‘ramped’ outside the hospital because emergency departments are ‘access blocked’ and unable to attend patients. Critical cases are always triaged and dealt with accordingly, which leads to less serious cases spending lengthy periods waiting for treatment. With my recent hand injury falling on a Saturday night I tried to avoid going through the lengthy wait time by attending a private clinic, clinical needs meant that I needed treatment only the public hospital could provide.

Other shortfalls include limited specialist doctors and lengthy wait times for those specialists, these wait times are often measured in years. Patients are free to go to private healthcare providers if they have the means to do so.
So there you have it the healthcare system draws funds from various sources, the taxpayer is only a partial and indirect source of funds…
 
Aunt Bea said:
The good news is that we receive treatment in medical emergencies and are not turned away if we can’t afford it.
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My wife was scheduled for a procedure, and we had not met our out of pocket deductible. The lady sad that our cost would be about $3,000. I asked her how much it would be if we had no insurance and with a few strokes on the magic machine she said $1,250. So she reentered everything and I gave her my AMEX for the $1,250 and got rewards points as well as the savings.
 
outlander said:
Admitted at the ER, two day stay at the hospital (42 hours).

One CT scan of the stomach and abdomen, 5 liters of saline water, intravenous antibiotics, a room for a day and a half, and blood work of course.

$16,200 insurance price
$6700 cash price.
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Wow. And we whine here that we have to pay 800 ourselves or 400 if you pay 20 a month extra. I pay 120 a month. But when I called the doctor when I had shingles they didn't even pick up so I fixed that myself with some tiger balm. And another flipside: They kept pushing my mom to kill my dad. Yes mrs you must understand that it costs a cent to keep him alive. My sis is a doc and she helped her and shut her up.
 
I should have updated earlier, sorry.

The total insurance price was $26,000 and the cash price was $10,500. So my bill was discounted 10% for paying in full, total $9450.

In addition to that I was billed $2100 independently from 2 doctors that gave me a 10 minute consult for $2100. Again that was discounted to $1400 for paying in full.

So I got a super deal, how lucky am I?

I might mention that Bronze coverage from the marketplace would have cost thousands more out of pocket because the billing would have been based on the full insurance price. You pay a $9000 deductible and then 50% of the remaining bill. So approximately $17,500, an even better deal thanks to the awesome Bronze coverage ;)
 
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With each level of insurance, you are paying for all those who process it, review and set up plans.

I worked in insurance on many aspects and was generously paid for little work.
During the roll out of the aca, I worked for a blue cross plan
Many people who were to process the enrollees. due to people making several accounts and trying to find a plan, we had people who had duplicates and triplicate applications. Processors told supervisors if they sorted to eliminate the duplicates or have them all together, we would need half the staff.
We were told "we do not know they are duplicate". I guess the exact same names address DOB and SSN were pure coincidence 😄😄😄😄.
we had to contact person after managers finally caught on took days to hear back then some went back on website and managed to sign up for 2 more times and put the process back to step one....:unsure:

I opened incoming mail and routed many items could have been cleared up ASAP but nope put into a pool of people who cherry picked and took their sweet time. It was a joke how it was run.
One guy was wrongly listed as woman and that was a problem to have some procedures paid for.
The guy sent in photo of driver's license had passport finally a very graphic photo to prove him point...lol
It was a simple change on computer of would take 2 minutes they had a conversation lasted a half an hour. They were upset it would show a mistake on their part. :oops: .

Many other letters after covered person had DIED and insurance was notified but yet the premiums still on auto pay felt bad for families that got so much run around to just fill three lines on computer to stop it.

Each application or adjustment went thru 3 layers of people who also had time to knit and watch movies at their desk seriously. The other side of claims was worse.
I quit shortly after that ....

The days were filled with snacks or candy provided by company and many cheerleader type rallies. lol

If you are paying 15 ppl from insurance company before you even saw the DR it adds up. That is why they are fighting price transparency so hard.
 
outlander said:
Admitted at the ER, two day stay at the hospital (42 hours).

One CT scan of the stomach and abdomen, 5 liters of saline water, intravenous antibiotics, a room for a day and a half, and blood work of course.

$16,200 insurance price
$6700 cash price.
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And this is why "medical tourism" has become a popular option. Not only is it cheaper to have medical procedures done in other countries, even considering the airfare and stays, the quality of care is good and in some places purported to be excellent. I read about one facility, forgot in which country now, that the hospital setting looked more like a hotel room.

Mexico is mentioned as one of the top medical tourism countries below. I have friend who hooked up Eons, the now defunct senior site. They moved to Mexico together and have been there for years. The man had to have part of his leg amputated. It was done there and he was very happy with the procedure and the care he received.
13 Top Countries for Medical Tourism (Cheap + High Quality)
 
OneEyedDiva said:
And this is why "medical tourism" has become a popular option. Not only is it cheaper to have medical procedures done in other countries, even considering the airfare and stays, the quality of care is good and in some places purported to be excellent. I read about one facility, forgot in which country now, that the hospital setting looked more like a hotel room.

Mexico is mentioned as one of the top medical tourism countries below. I have friend who hooked up Eons, the now defunct senior site. They moved to Mexico together and have been there for years. The man had to have part of his leg amputated. It was done there and he was very happy with the procedure and the care he received.
13 Top Countries for Medical Tourism (Cheap + High Quality)
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We had friends who lived in Costa Rica because they enjoyed it there, but mainly because one's mother was elderly and needed constant medical attention. He was a doctor and indicated her care was exceptional and relatively inexpensive. They moved back to TX after she passed away to be close to their kids/grandkids.
 
RambleTamble said:
This is one reason insurance is so expensive...

An analysis of the seven largest publicly traded U.S. health insurance companies (UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina) suggests they made a collective $71.3 billion in profits last year (2024).

If we got the profits out of health insurance, it would be a lot cheaper.
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Someone could just take their profits and invest it in medicare for all, including ears, and teeth. Sure, someone would probably keep it for themselves, but on the off chance ....
 
RambleTamble said:
This is one reason insurance is so expensive...

An analysis of the seven largest publicly traded U.S. health insurance companies (UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina) suggests they made a collective $71.3 billion in profits last year (2024).

If we got the profits out of health insurance, it would be a lot cheaper.
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Yep, it would save every one of us $195 per year, less than $4 per week. A lot cheaper???
 
seadoug said:
We had friends who lived in Costa Rica because they enjoyed it there, but mainly because one's mother was elderly and needed constant medical attention. He was a doctor and indicated her care was exceptional and relatively inexpensive. They moved back to TX after she passed away to be close to their kids/grandkids.
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Right. You have many options in central/south America if you can speak Spanish. But if you don't speak spanish...
 
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OneEyedDiva said:
And this is why "medical tourism" has become a popular option. Not only is it cheaper to have medical procedures done in other countries, even considering the airfare and stays, the quality of care is good and in some places purported to be excellent. I read about one facility, forgot in which country now, that the hospital setting looked more like a hotel room.

Mexico is mentioned as one of the top medical tourism countries below. I have friend who hooked up Eons, the now defunct senior site. They moved to Mexico together and have been there for years. The man had to have part of his leg amputated. It was done there and he was very happy with the procedure and the care he received.
13 Top Countries for Medical Tourism (Cheap + High Quality)
Click to expand...
A friend flew from FL to Mexico for extensive dental work. He was quite pleased with the work and the cost.
 

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