I paid about $1750 in insurance premiums last year and an additional $9,000 in deductibles. This year should be a little more in premiums and hopefully, just $7500 in deductibles. (Wife was treated for cancer last year and had reconstructive surgery this year. I had a routine colonoscopy for the higher expense that I won’t need again for a few years. )

My insurance is probably better than most since my employer is huge.

It really depends. Some people have insurance that limits their liability to $500 or whatever for hospital visits, but if so they probably are paying a lot out of each paycheck for that.

I have family coverage and this plan pays essentially zero towards anything, except pays 100% of the annual wellness visits to GYN, GP, and dermatologist, any vaccines considered preventative too. Then there is a "deductible " of 6,850 per person with a maximum of 8,000 a year, then it would then pay 80% of anything above that $8k until we paid $16k, then it would cover 100% of anything above that. So basically it really is “insurance” not healthcare.

Which would be ok except that the plan itself costs almost $7k a year in premiums. I am not getting that much value out of it. And that’s not even the total, my employer is paying some too!

So most years this costs us in total maybe 8,000, the premiums plus a couple of visits and any drugs.

The only people winning in this system are the insurance companies, the one who owns our plan made revenue of $371 billion last year and a net PROFIT of $22 billion.

Oh and as you are asking about uninsured, I was for a long time, and you have to negotiate your own prices in that case, argue for a cash price. And hope nothing big happens. The mammogram cost almost $600 when I had to get a diagnostic one, colonoscopy $1,500. Childbirth, at home with midwife including all prenatal about $8k. Doctor visits between $80 and $200.

I’ll put it this way:

At least 68,000 Americans die every single year due to not being able to afford healthcare.

We pay an extra $450 BILLION annually to enrich unnecessary middlemen and ALL of our politicians are being bribed (or primaried) to prevent Single Payer. You’ll hear people like Kamala and Warren talk about “access” to healthcare while they receive massive bribes from healthcare companies to pull support away from Single Payer and offer a “choice” or “access to health care”. Remember 2016 and 2020? The DNC pulled out all stops to prevent Single Payer. Remember when Bloomberg ran for office and claimed , “under my governorship, New York had less uninsured people than at any time in history” while failing to mention that he enacted steep penalties for being uninsured? That’s neoliberal gaslighting 101! Kamala loves to do it too! But yeah vote for her because she’s “one of the good guys” and certainly wasn’t one of the people that was tasked with preventing Bernie Sanders from winning the primary two cycles in a row, offering “Medicare for All who want it” so stacked with asterisks and legalese means-testing that probably like 50 people would qualify.

Edit: In my opinion, anyone who is paid to run for office and vote against Single Payer is a murderer guilty of (or at least partly responsible for) the slow, often-painful execution of these 68,000 American citizens per year.

I have student loans that I’d love forgiven but I don’t even mention that issue because true Single Payer (and Gaza obviously) are my moral lines in the sand that almost everyone in Congress except Rashida Tlaib has brazenly trampled.

https://www.newsweek.com/medicare-all-would-save-450-billion-annually-while-preventing-68000-deaths-new-study-shows-1487862

https://www.sanders.senate.gov/wp-content/uploads/Fact-Sheet_Medicare-for-All-2023.pdf

Consider that most Americans are pay 2x to 5x more in insurance premiums each month than folks in the 32 other developed nations with national healthcare coverage pay monthly in taxes for health care. Consider that Americans still pay deductibles and copays. Consider that insurance won’t cover pre-existing conditions (which are many). Consider the insurance frequently denies claims and requests for further tests and specialists. Consider that most insurance only works within the limited network of the insurance companies designated healthcare providers.

I work a multinational company that has moved staff from Japan, Canada, and the UK to the USA for periods of work. All of these folks were shocked and horrified by the American insurance system.

$896 per month in premiums, and about $18k out of pocket so far this year in addition. Me and two kids.

We pay $500 a month for family “health care” because we’re forced to. Every doctor visit I go to I get a $40 bill just for walking in the door, on top of paying for my medicine copays. It really sucks.

Firstly, thanks everyone for all the responses. I appreciate it, and I hope that some of you felt better after having a vent.

American friend predictably says there’s a problem with “healthcare literacy” and that you just don’t have to pay the bills and they probably won’t chase it up. I don’t beleive that at all.

I figured it might be interesting to share how much I pay for stuff up here in Scotland.

I have a decent well paying job so I pay some money to the NHS in taxes, specifically ~£2000 a year. I get antidepressants and doctors appointments completely free from that. Dental I don’t get free because my income is too large, but it’s only like £20 for most routine things. I have a free eye test booked next week, and I splurged £10 extra to get fancy 3D imaging stuff done.

I do require mental health treatment though, and the NHS doesn’t cover that for autistic people (as a competence issue, rather than a policy choice). A session with a counsellor costs £45 per hour for me privately.

Honestly, the surprising thing to me isn’t that you have an insurance system (Switzerland has a similar thing, iirc), it’s just how inflated prices are compared to here.

I read something from last year that said about half a million Americans go into bankruptcy due to medical debt each year.

That’s it, that’s what happens. You lose everything and you start over, if you’re healthy enough.

Protect your NHS.

I pay $50/mo and then $25 for appts and $50 for ER visits.

It is true that nobody pays the cartoonishly high bills that you see posted online. It is also true that we spend way more on healthcare than basically anyone else.

My company offers very good insurance. Anything “in network” is free after the first $3000 every year, and the monthly premium is around ~$330. Note that this is a company that intentionally offers very good health insurance so they can be less competitive when it comes to salary and time off. I’d say in a given year, I spend around $7,000.

But really, one of the biggest practical issues with our healthcare system is its opacity. Most people are unable to figure out what most things will cost them before they consent to care.

nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals.

Sometimes there is an elaborate dance between the two on pricing. Sometimes the insurance company dances on its own to determine why the service is not covered.

If you don’t have insurance, the cost is lower

Depends what you mean by cost. insurance is always out to make money, that means paying less, and negotiating lower prices with providers. However, there are some situations where it benefits both the service provider and the insurance provider to inflate the initial price, and negotiate a steep “discount” to a final price (a portion of which the patient pays) that is higher than the non-insurance price. But I don’t remember the exact details, and I may be conflating this with some other healthcare industry scheme.

or removed entirely. Supposedly.

If a hospital is nonprofit, I believe they are required to have a (self determined) charity care policy that they must follow. If you make below a certain amount, you can apply for relief, but that also applies for to after-insurance costs, not just no-insurance costs. For-profit hospitals will rake you over the coals and send collections after you. Part of the problem with charity care, is that you may have to ask for it, and few people know enough about it to do so. And you may have to ask for it in the right way. If you aren’t specific enough, they may offer you “financial assistance” which is just a payment plan. Then they’ll treat you the same as a for-profit hospital would.

If you’re interested in a deeper dive, the Arm and a Leg podcast is a great show about healthcare costs in the US.

You may have heard about “Obamacare” or the “Affordable Care Act”. This did a lot of things which helped some but also did not do much.

For example, insurance premiums can cost hundreds of dollars per month, but if you get subsidies you can reduce that cost down to, potentially, zero. Unfortunately these subsidies are in the form of tax credits, which means if you don’t work you do not get any subsidies.

Additionally, if you happen to live in a red state, then your state probably didn’t expand Medicaid. Medicaid is the government insurance for poor people. If your state didn’t expand it, then your state only gives Medicaid to families and disabled people (basically). So if you don’t have kids, you don’t qualify for it.

For me, this means that when I stopped working and got insurance through the ACA, I had to pay $500 per month in health insurance premiums (dental and vision are separate insurance plans and not typically covered in standard health insurance). Did I mention this was while I wasn’t working?

With that $500 per month, I still had a $900 deductible (so I had to pay $900 before the insurance company would pay anything). After that $900, my insurance company paid different rates depending on the service (often called coinsurance). A common percentage is 80/20, which means insurance will pay 80% and you will pay 20%. So hospital bills tend to be thousands of dollars. BUT insurance plans also have what’s called an “out of pocket max” which means your insurance will cover services at 100%. So any medical things you do after that magic number are basically free for you (you still have to pay the premium).

Ok, but you might have also heard that elderly folks have their own government insurance - called Medicare. Medicare is also available for disabled people like me.

Medicare is confusing AF. It has multiple parts to it - I will only talk about what’s called “traditional Medicare”, which basically means everything is between you and the government (There’s other Medicare plans through private insurance companies, and those plans are similar to what I described above).

So with traditional Medicare there’s Part A (hospital), Part B (basically outpatient services), and Part D (prescriptions). Part A is free for most people, part B currently costs about $75 per month, and part D varies but is much like the private insurance above. If you only have part A, then only hospital visits will be covered. If you only have A and B, then none of your medications will be covered! It sucks.

So remember how I said about the deductibles and coinsurance? So Medicare has their deductibles and coinsurance separate for each part! For my part A, if I go to the hospital, it comes out to about $1300 per DAY, but only for short hospital stays. Oh and that’s only for room and board. Longer hospital stays have different rates. Also, if you stay in the hospital too long, it starts going against your lifetime hospital days. That’s right, if you use up all your lifetime hospital days, then Medicare will just…not cover your hospitalization anymore. Ever. For the rest of your life!

And don’t forget you still have to pay extra for any imaging, medications, and doctor visits you had while in the hospital because the daily rate is basically for the bed.

Part B is a straight 80/20 coinsurance. But part B also doesn’t have an out of pocket maximum. So if you have a lot of outpatient procedures, then you will end up paying out the nose for it. Currently I basically just end up paying around $30 for each doctor’s appointment (not including lab work or any procedures).

Part D depends on what plan you get. Mine was basically 80/20, which means I was going to have to pay outrageous amounts for medications! I’m on like 25 medications and it was going to be hundreds of dollars each month just for the prescriptions. Luckily, we have programs like GoodRx! Which is basically a coupon but for medications. Unfortunately, you can’t use insurance if you use GoodRx. Also, the pharmacy won’t usually automatically compare the prices to see which method would come out cheaper for the patient. Oh, also, each pharmacy has a different price for the same medication! I’m not even talking a few dollars. Some medications can be hundreds of dollars different in pricing depending on which pharmacy you go to! And it’s not consistent either. So basically if you’re on Medicare you get to go on GoodRx every month for each prescription and see where you can get it the cheapest at and then either ask your doc to send it there or try to get it transferred. Imagine doing that with 25 prescriptions every single month!

Luckily for me, I qualify for what’s called “Extra Help.” This program pays for my Part B premium ($75) as well as part of my part D premium (it was about $100 but with the help it’s down to $75). They also bring all my prescription costs to $1.55 per medication per month. Unless it’s a brand name medication… 😬

If you’re following, when I had private insurance I was paying $500 per month in premiums alone, plus about $50-100 per month in doctor’s visits, plus about $50-100 per month in prescriptions until I met my out of pocket maximum. Then just the premium.

Nowadays, I have Medicare + Extra Help. So I pay $75 per month for my prescription premiums, plus currently about $200/month in doctor’s visits, plus about $50/month in prescriptions. So it comes out cheaper currently but if I have to go to the hospital again…well, I’m fucked.

By the way, most insurance plans do not have out of network coverage…so if you go somewhere that doesn’t have a contract with your insurance company then you will probably have to foot the bill. And a lot of the charity programs that hospitals and doctors have won’t let you apply if you have insurance soooooooooooo…

A few years ago, I went to a treatment center for a few months. My total bill was almost $200,000. My personal portion was supposed to be around $15,000. Did I mention I wasn’t working? Right. Luckily the treatment center enjoys the tax benefits they get when they write off people’s bills, because they wrote mine off. I still had to file for bankruptcy though, because that wasn’t my only medical bill.

PS insurance is often provided by your job here so if you lose your job you, at maximum, have until the end of the month with your insurance :) so don’t quit your job at the end of the month ;) there is a thing called COBRA which is supposed to bridge the gap between jobs, but it’s usually something ridiculously expensive like $700 per month for a single person’s premium (yeah, you have to pay more premiums if you want your spouse and/or kids to be covered).

If you are and remain healthy it is very expensive. If you get sick or injured or ill

It costs more than you have

A lot.

Put it this way: like 70,000 people die in the US each year from lack of healthcare due to the cost.

Health insurance is a profit-driven industry, so denying claims for those that DO have health insurance is standard practice.

Most don’t see an actual physician. The average clinic visit takes about two hours after everything is said and done; you engage with a health professional a median of 12 minutes.

People drive themselves in serious medical distress or try to take an uber to the hospital instead of an ambulance.

Doctors themselves hate the medical system in the United States.

Nurses are fleeing the industry. Projected shortage of 80,000 nurses in 2025. “About 100,000 registered nurses left the workforce during the past two years due to stress, burnout and retirements, and another 610,388 reported an intent to leave by 2027.” This while baby boomers consume more and more medical resources as they age.

Medical bills are the #1 cause of bankruptcy.

So, it’s not great, no.