American Healthcare - Scary

[Saltcreep]

Nothing serious, but I just had my first experience with American healthcare and, let me tell you, it's scary. I'm down here in Florida with my 'Snowbird' mom and she has developed an infection in her leg. As she is diabetic, we decided to go to a local walk-in clinic to get it checked out. Mom has good out-of-country health insurance and has used it in the past at the hospital emergency for a knife cut, so you'd think, no issues. In hindsight, we probably should have gone to the hospital emergency because the first surprise was the clinic doesn't accept any Canadian insurance coverage. O.K. then, how much? $134.00 dollars for the visit; we'll take cash, MC, Visa or your firstborn. Medications, treatments, injections - all extra.  Weighing that against the trip to the ER and the likely wait time, we opted to stay with the clinic. Got out of there with a prescription for a very powerful antibiotic, instructions to monitor the infection carefully and wear a compression bandage or sock. Not too bad so far - I liked the doctor, he was very thorough and his diagnosis made good sense. On the way back to the condo we dropped off the prescription at the local pharmacy. The pharmacist took all the appropriate info and then asked "how will you be paying for this"? Mom says, "well, I guess that depends on the cost". The reply - "this is a very strong antibiotic, the cost will be $240.00". That's for one pill a day for 14 days - 14 tablets. I have no doubt the outcome will be good and I'll probably be here a few extra days to monitor the effect of the antibiotic - not a bad thing . One other thing, while I was waiting for my mom, five other patients came into the clinic. Each was asked what their insurance coverage was and all five answered "none".  Man, be thankful for what we have in Canada. I had to vent, my head is still trying to get a grasp on what people do here when they really get sick. And, they still resist "universal healthcare', or their version of it, with a passion.

[Nerine]

wow that is crazy...I haven't had a run in with American healthcare in ages and am happy for that!!
But being from California, I know all too well how bad it can be...$400 for a 10 minute ambulance ride for a friend, and $500,000 for my grandfather's hospital stay - including brain surgery, medications, therapy etc...and that's the part insurance did NOT cover...that happened several years ago and the family is still paying it off. I don't understand at all why americans don't want their healthcare system to change.

Hope your mom's leg heals quickly!!

[Brent Shaver]

I lived in Texas for 2 years and couldn't agree more, anything medical is outrageous.

My girlfriends dad had a motorcycle accident and once it was all said and done they owed $280.000 and he had what they said was excellent insurance.

Medical in the States is in the top 5 for reasons people file bankruptcy.

[FocusFin]

In hindsight, we probably should have gone to the hospital emergency because the first surprise was the clinic doesn't accept any Canadian insurance coverage. O.K. then, how much? $134.00 dollars for the visit; we'll take cash, MC, Visa or your firstborn. Medications, treatments, injections - all extra. 

This should not preclude you from having the charges reimbursed by the insurance company. It's important to contact your insurer prior to treatment to clarify/verify what is covered.

It's not unsual for private clinics in states like Florida to refuse foreign medical coverage when they see so many international vacationers. Picture Betty Sue Flowers from Ocala Family Medical trying to verify insurance coverages with Kalpona Biswas of Jiban Bima Insurance in Bangladesh. Those southern drawls can be hard to understand 

[Saltcreep]

Actually, it was pre-cleared with the insurance company, we even had a claim number. As I said, the coverage is good and has been used at the ER before with no issues. They had asked for the phone number of the clinic and said that they would call them to verify that the visit would be covered and provide them the claim number and procedures. Simple fact is, this clinic does not accept Canadian insurance and this is not a small operation; they have many branches in the area. Especially, troubling because this clinic is located in 'Snowbird Heaven'. By Christmas, the number of cars in the condo parking lot from Québec and Ontario will outnumber those from all of the states combined, I've seen it. I have since contacted the local hospital about their acceptance of Canadian insurance and their reply was, "Oh my, yes, of course". The hospital here also took care of my dad when he had cardiac issues about ten years ago. The care he received was top notch with no insurance worries whatsoever. We will also be looking for reimbursement of the costs, but there is a small one-time deductible on the coverage that may may make that more trouble than it's worth.

[FocusFin]

I have since contacted the local hospital about their acceptance of Canadian insurance and their reply was, "Oh my, yes, of course". The hospital here also took care of my dad when he had cardiac issues about ten years ago. The care he received was top notch with no insurance worries whatsoever.

The private clinics don't have the budget and manpower the hospitals do. To provide care upfront pending payment, billing and verifying each patient's insurance coverage can be costly and taxing.

It's not a lot different from Canadian health plans. We recently had my daughter in to see a psychologist for attention issues and paid $175.00 upfront and had to wait 3 weeks to be reimbursed $60.00 by the insurance company. You would think that there would be some type of assistance from OHIP but there isn't.

[Saltcreep]

......
It's not a lot different from Canadian health plans. We recently had my daughter in to see a psychologist for attention issues and paid $175.00 upfront and had to wait 3 weeks to be reimbursed $60.00 by the insurance company. You would think that there would be some type of assistance from OHIP but there isn't.

True enough. I'll still take our system over the American model a thousand times over. I expect most Americans would also if they could just understand it. Their fear of Big-Brother type government and control completely overrides common sense. I had quite a lengthy conversation with one gentleman yesterday while I was waiting, about our differing healthcare systems. To say his viewpoints were 'way out to lunch' would be a major understatement, but that's from a Canadian's viewpoint. When he finally went to the reception desk to hand in his five-page questionnaire, he showed me where he had entered his primary insurance coverage. He had written "ObamaCare - NONE".

[markw]

I know a man in Florida who we met through work who managed an airport facility. He was 48 and on New Year's Day(while at work) collapsed and has been in a coma since. His stay in the hospital was obviously covered by his work insurance. Until the day it expired(60 days after incident)! Since the family couldn't afford the payments to the hospital, and work insurance ran out, they transported him home. He gets daily visits from a nurse the family and donations support. I'm sure we all know horror stories like this.
What scares me more, and I don't want to steal your thread( not sure if that's what you call it), but Ontario has changed the auto insurance coverage drastically to impact accident victims. Things we have always taken for granted were covered by our health care coverage, now may not be. This all changed September 1, and I'd sure be happy to hear from someone who really understand this, but I understand that even if an accident isn't your fault and if you didn't buy "extra" coverage you might be in the same boat.

[Nerine]

our insurance company sent us a letter regarding changes...but there were no details! Just said "Important changes that will affect your policy are happening" and there was a note saying they would follow up with more info....
hopefully we have enough coverage very scary

[Saltcreep]

A short update. We just returned from a shopping expedition to find a message from the insurance company on the machine. Called them back and they explained they were following up on the pre-approved claim because they had received nothing from the clinic. We explained what had happened, that we paid cash, and she said she would have a claim form in the mail by tomorrow. Just attach the original receipts from the clinic and pharmacy and they would have a cheque in the mail as soon as they received it. That's the kind of service I like.

[Laura]

That's great that you'll get reimbursed.

I agree that even with the issues our health care system has, the system itself is so much better.

We were in Florida in Feb at Disney and an American asked me about our system. I thought it was interesting that he was so politically dis-similar to me (we discovered that in the first 60 seconds of conversation), but he was still distrusting of the line that they were being fed about the horrors of the Can. system.

I told him that while I could give him some negative stories, in general I'm really happy with the care. I gave him a simple example that my son hurt his foot, and a neighbour (who's a doctor) wasn't sure if it was broken so suggested we went to CHEO. It made for a late night, we had xrays, nothing was broken and we were done.

He said that a visit like that would have cost $3000 - personally, I like not having to worry about that and being able to bring my kids in for care without worrying if I can afford it.

A friend of ours is having some chronic health problems, his wife is American and only moved here in the past 10 years, he's Canadian. I asked her whether she was happier dealing with his health problems under the Canadian or US system - she said that the insurance companies would probably refuse to insure him at this point citing pre-existing health conditions.

All that said, I think we should also publicly fund dentists, eye doctors and psychologists. They are all essential to good health.

[holachicka]

I think we should also publicly fund dentists, eye doctors and psychologists. They are all essential to good health.

I agree - Just the dentist as an example, a lack of proper dental hygiene can lead to heart problems (to name one) that are very expensive on the health care system...what is more expensive, prevention or treatment?! I would say prevention!

[Hookup]

Speaking with several Americans, I was told that US citizens pay more for their health care than we do, by percentage of annual income tax.   I cannot remember the percent to percent comparison exactly, but that blows your mind doesn't it?

[mseguin]

Sometimes we need to be reminded how darn good we have it here eh?

[Saltcreep]

Sometimes we need to be reminded how darn good we have it here eh?

Oh yeah!!! And not just health care. I have so many stories I could tell.

Don't know if I'm allowed to do this, how long the link will be active, and, I'm jacking my own thread, but here's one little example ..

http://www.newsherald.com/articles/panama-87793-continue-renewals.html

[RoxyDog]

All that said, I think we should also publicly fund dentists, eye doctors and psychologists. They are all essential to good health.

I think that eye doctors are paid for up to a certain age, 16 perhaps?  It should be the same for dentists IMO.  It would be nice to have both of those paid for at any age especially when you're like me and glasses cost you $500...and it's not like I can choose not to wear them!  As for psychologists, no they aren't covered but psychiatrists are I'm pretty sure.

Glad to hear your insurance company provides such great service.