How does the medicine in the US
Important Note: The information set forth in this post is collected from a variety of sources, including my own experience, and may include inaccuracies or errors.
Before we talk about how the medicine in the US, you need to talk about how the state machine in the states. State considers that the main thing is the market and competition. By this is meant that the state should first and foremost ensure that, so that no monopolies, cartels, corruption schemes and other forms of unfair competition, and all the rest will be self-regulating market. This all implies a minimum of government regulations and restrictions in all areas except for critical services, one of which is the health care system.
The cost of medical services:
Medicine in the states is not just expensive, but incredibly expensive. Bills for medicine is the most popular American bankruptcy factor. Here is an example of my accounts for understanding about the price:
- The child clung tick. We went to the emergency aid. We stayed there for about half an hour. The doctor simply removed the tick, he said how long he latched on and everything. The bill for this was 421 dollars.
- His wife was not good, we again went to the emergency aid, stayed there for about 4 hours. The bill for this visit of 3500 bucks.
- Colleague with kidney stones went to the emergency aid, stayed there for about 6 hours. Account was 6500 bucks.
- Childbirth cost of 10,000 dollars.
- A visit to the doctor on duty for examination of the child costs $ 150
- The cost of the operation can be tens of thousands of dollars.
From a conversation with the American colleagues it becomes clear that the Americans by and large do not know where are these prices.
Various versions of a lot:
- Medical Mafia
- A huge number of government regulations - Non-transparent pricing. The bill for the exact same service for different people can vary dramatically.
- Very expensive insurance for hospitals and doctors who are bought to protect against patient lawsuits.
Without health insurance in the United States in any way. If you have any health problems more serious cold and you do not have insurance cheaper die.
In the states of several different types of health insurance. According to one type of insurance you every year you pay out of pocket for example $ 800, all the top paid by the insurance. On the other, you only pay a fixed payment mandatory for reception (copay), the rest is paid by the insurance - I have this variant.
What is a copay: after visiting the doctor you pay a fixed part and a small payment.
sopay size of my insurance:
- During a visit to the doctor or emergency (urgent care) assistance to $ 30
- During a visit to an urgent care $ 150
- Childbirth $ 250
Why this sopay needed: two words that patients do not zadalbyvat doctors and insurance fictitious diseases, which is why every visit is worth the money.
The last major reform of medicine was about half a century ago. According to this reform, the government has decided that honey. insurance should be provided free of charge to help older Americans. The company began to provide insurance to employees. The money that companies spend on insurance to be tax deductible. For the most part, when an American goes to work, his employer provides insurance, part of which pays the employee himself. If the family employee, insurance extends to his family members and children under 21 years. The sum which the employee pays for insurance is deducted from the wages and is not taxed. After Obama's health reform, the state began issuing honey. insurance to the poor through special service. As far as I am aware, such insurance shall be issued with a very big discount. What to do if there is no insurance and no money? You can just as well go to the hospital and the hospital does not have the right to refuse care. In the hospital itself understand that they will pay the money no one will, but it has nothing to do - it is one of the factors of growth of the cost of services. Those who have money to pay the costs of clinics from those who have no money.
It is also a very important factor is that insurance companies do not work with all hospitals and all doctors. All with whom they work are considered to be in the network (In network), all others are not in the network (out of network). If you come to the clinic, which is not on the network of your insurance, the situation is bad, the insurance, depending on the policy, may refuse to pay at all, or pay only a portion. Moreover, even the doctor who runs the clinic that "network" can not be "in the network". One of my colleagues, got into the "Emergency room" clinic "in the network", and the doctor who treated him was the "offline" and only after long conversations insurance agreed to pay 1500 bucks for that physician services.
It is important to note that the law limits the profitability of insurance companies. They can leave themselves no more than 20% of the money. All the rest of the money should be spent on insurance premiums.
The cost of insurance for the family, in my case, $ 500. For one employee about 100 bucks a month. Insurance dentistry includes a bunch of restrictions and sight (vision).
Vision in the states is a separate type of medical services in the private clinic.
It is important to understand that the insurance provided by the company. Conditions, the cost and quality of the insurance itself vary greatly from company to company. For companies, good insurance is a kind of competitive advantage to lure employees.
Forms of care:
- Just a visit to your doctor if you have something ill, regular examination of the child, vaccinations, and other non-urgent medical services. In this case, it is necessary to call the registry and make an appointment with your doctor. May appoint the same day, the next day or two. Payment copay such a reception in my case 30 bucks. - You have something has happened and you need to chat tonight to get to the doctor, but it is not deadly is the already urgent care. You come to the clinic during business hours. Waiting to turn and get to a doctor, who decides what you do next. Payment copay such a reception in my case 30 bucks.
- If you wake up in the middle of the night and feel that the scribe did come and you need to urgently to the doctor, then your only option is the Emergency room. As an option is to call an ambulance or drive to by car or taxi. Call ambulances in case if it is not covered by insurance can cost 800-1000 dollars, so it's best to get all the same for yourself.
The Emergency room you immediately send to the House:
Soon you will come to the nurse will measure your temperature, pulse, blood pressure and make the computer all the necessary information about you and your complaints.
After the nurse has finished all the preparatory work, the doctor comes and starts inspection. The doctor may then refer you for tests if they can not take place. For tests you will carry on a chair. In the case of the need for surgery, you will immediately be taken to the operating room. Payment copay such reception in my case 150 bucks. The bill, which the clinic will expose the insurance at a more or less serious case, measured in thousands of dollars.
In a nutshell. Medicine quality is very, very high level. I'll tell you the example of the birth of my youngest son the procedure.
Interesting fact: Eng. Language is such a word as "Delivery", which refers to the delivery of something. When you postman brought a parcel Delivery is, when a courier brought you pizza is also a Delivery, so, delivery is also Delivery.
Let's go back to the birth. On the appointed day, my wife and I arrived at 7 am in the hospital. We performed a generic chamber about how the pictures:
Spouse helped to dress in special attire and connected to the two sensors and pulse to fight, and then she lay down on the birthing bed. Interestingly, the highly appreciated if the House are present at birth close relatives in the states. Especially for them, there is even a sofa. Relatives not wear shoes and clothing is not necessary.
During the whole process of giving birth to the next to be at least one nurse, at one point there were just two. Nurses changed every 4 h. Nurses who finished a shift, a new nurse led and represented her.
For giving birth in which English is not the native certified translator must be present during the entire process. Translator provides the hospital itself.
At some point, his wife took a shot into a vein. Prick a nurse, and she made two attempts. According to the regulations, more than two attempts, the nurse can not be done, after two unsuccessful, it must call the anesthesiologist. Doctor coped with the first attempt.
At one point, we were led intern doctor. She is a very long time apologized and asked permission to ask a few questions and be present at the birth process.
After that, to us a few times came a procession of two or three doctors, who controlled the entire process. It is important to note that all the honey. staff was very polite and welcoming. Everyone was very patient and very considerate - personally I was very much surprised and pleased.
There was also a kitchen with a refrigerator, in which there were juices, ice cream, some sandwiches and other edibles that could be taken.
In general, about the birth process itself can be quite a long time to talk, but I was more excited by everything from personnel, equipment from the clinic, on a clear order in all procedures. Impressions were particularly striking in contrast with the first child birth process. The doctor, as I later learned, had behaved like a complete asshole, and I paid him extremely good money in those days. Good - it is his monthly salary. The entire delivery procedure cost about 10 000 dollars of which I paid 250 and which I then returned to the company in the form of bonuses, for which my office, thank you very much!
I hope that on such a small sample, it became clear that the level of medicine at a very high level.
Come to the pharmacy and buy any medicine just can not. Just because you can buy vitamins, antipyretic and something similar. In all other cases, we must get a prescription from a doctor. The doctor sends the prescription itself in your pharmacy. After all medicines are prepared, the pharmacy staff member will call you and tell you can pick up the order.
Medicines themselves, too, are covered by insurance, you have to pay only a certain percentage of their value. All financial calculations with your insurance pharmacy conducts itself without your participation.
Interesting fact: drugs to prevent pregnancy insurance cover completely, ie 100%. The insurance company decided to pay for contraceptives that are much cheaper than to pay 10,000 dollars for generations.