Insurance, healthcare provider, apparent abuse, lack of transparency
"Just as with any other service provider - vote with your wallet. Do not go back to that doctor's office, and make sure they know why. It's unheard of that a service provider will not disclose the anticipated charges ahead of time. A service provider saying ""we won't tell you how much we charge"" is a huge red flag, and you shouldn't have been dealing with them to begin with. Now you know. how can we ever get health care costs under control if there's so   little transparency? I'm assuming you're in the US. This is not going to change, since there's no profit in not screwing the customers. As long as health-care is a for-profit industry, you should expect everyone in it being busy figuring out a way for money to move from your wallet to their. That's what capitalism is about." I wouldn't classify your treatment as abuse. Medical billing has become more complex not less complex. You need to learn to ask even more questions regarding expenses, you probably need to see these price quotes in writing. You did several things correctly. Staying in-network generally is best because many plans have two deductible limits: In-network, and out-of-network.  You need to make sure that the insurance company does credit you with having paid the new patient fee. That will qualify as an expense toward the deductible and your maximum out of pocket for the year. Some doctors offices don't send to insurance companies items that they know will not be covered, not remembering that these costs are critical under the High deductible plans with a health savings account. Doctors offices have problems determining how much the cost to you will be. It depends not just on the insurance company but also which type of plan you have, which sub-plan you have, and are you covered by more than one plan. Not to mention individual deductibles, family deductibles, and annual out-of-pocket amount. All this is wanted prior to the doctor seeing the patient. Most doctors offices will work with you, they know that each insurance plan treats each medical billing code differently, sometimes they make a mistake. Talk to them.
&gt;Insurance should be based on binary states, and healthy/unhealthy just isn't an actual set of binary states.  Insurance is a financial risk mitigation product.  Binary states are irrelevant.  You buy insurance to make sure that if you have healthcare bills over some amount in a year, insurance kicks in.  That's it!  It's pure economics. Drug abuse is accepted reliable manuscripts base on mental health, neurological and substance abuse problems and service systems. We provide the best Drug addiction program in the United States.The indication of substance abuse is the addiction or dependence that has continued in spite of facing the side impacts or negative outcomes because of the utilization of that substance. There are experts who give treatment to substance utilize clutters. "&gt; That is in large part do to insane healthcare costs passed on to the consumers by the aca. Healthcare spending has increased on average 1.5% annually since 2009 where as the highest growth in spending from 1991 until 2006 was 1.3%  Health Care costs have actually been on the rise for decades now. It was only ""noticed"" by the majority party (i.e. the GOP who had held the majority for 16 of the years prior to 2009) when the ACA was enacted. Suddenly, health care costs ""started"" to ""explode"". The truth is that health care costs have been on a steady rise. In the time period from 1972 to 1982, costs rose on [average 14% per year](https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878). Keep in mind, this was prior to the expansion of Medicare. From 1983-1992 costs grew at a rate of 9% per year - 3 times faster than inflation. From 1993 to 2010, cost rose at a rate of 6.4% per year. The ACA of course was passed in 2009, but didn't start to take effect until 2011. Since 2010, health care costs has risen about 4% per year. That is a 2% drop in a short amount of time, compared to the previous years. However, the numbers are already so big, just like the national debt, that the GOP (who had as much part to play in the health care costs as they did in the debt) had tons of numbers they could use to make it seem like ""health care costs have exploded"".   In reality, what happened is that people who never had health insurance before were forced to get it, and started to realize how expensive it is when it actually covers what it was intended to cover - preventative care as well as emergent care. The GOP has been on a steady march to undermine the new law as much as possible since it passed, because it made some of their biggest donors (HMOs, and Health Care Insurance providers) uncomfortable the fact that they HAD to share their cost information, and that the health care exchange required them to do a line item by line item comparison with other companies out there.   So, here we are. The ACA is going to be cut, and millions of people are going back to be uninsured or underinsured. What you are going to see is the rate of costs growth start to increase again after decades of slowly decreasing rates. Why? Because of the renewed ability of insurance providers to hide the costs, to hide costs increases. It will also cause hospitals to greatly overcharge the uninsured, as they were doing before, but there will be many more of them. The goal being, that the uninsured are unlikely to pay for the (very large) medical bills. So, knowing this, hospitals artificially inflate the bill in the hopes of getting a larger portion of that unpaid bill liquidated through Medicare.   Uninsured populations also lead to more unhealthy people. You would think that not having health insurance would make people want to remain more healthy. However, studies show [the opposite to be true](http://www.slate.com/articles/business/the_dismal_science/2011/07/does_health_coverage_make_people_healthier.html). In actuality, people stress more about their health, and avoid periodic checkups. Both of which lead to bad health results.   Trying to blame the cost increases in health care on government ""meddling"", or say it is a problem brought on by the ACA is weird since there are [so many examples of government provided](https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#175cf39e576f) health care programs out there which are so much more efficient, less costly, and have resulted in much healthier populations.   &gt; I dont have health insurance and an ER visit with xrays costs me less out of pocket than 90% of the country why is that?   I am going to call BS. Number one, that is a huge claim to make without supporting evidence. Number two, you would have to demonstrate how much that same visit would cost to those *with* health insurance.   &gt; Do you think it has to do with the fact that with the aca hospitals know they are getting paid with 0 questioning on pricing so charge whatever they want and with me they think ""shit this guy might not ever pay us lets just give him a decent price and get some money from him because all we can do is send his bill to collections""   Actually, no. The [exact *opposite* happens](http://www.alternet.org/story/16466/why_hospitals_overcharge_the_uninsured). They now, because you are uninsured, that you are unlikely to pay. So they *overcharge* you for the same services because they know that they will only be reimbursed a percentage of the costs if it goes to Medicare for non-payment.   &gt; The swiss do everything better,  You keep referring back to Switzerland. Don't get me wrong, they are a very good country, and have the number 2 ranked health care system in the world. However, I don't think they are the low tax haven that you think they are. They have an [average corporate tax rate of 17.2%](https://en.wikipedia.org/wiki/List_of_countries_by_tax_rates), whereas the US has it at 32%. Their highest income tax bracket is 13.2, whereas the US is at 39%. Their sales tax goes at high as 8%, where ours go as high as 11%. Their [average effective tax](http://www.economist.com/node/14340551) rate is around 11%, while ours is around 18%. Including Social Security puts Switzerland at 17%, and the US at 24%.   So, they are definitely a lower tax rate country, but in no way are they a no tax rate country. Then again, Switzerland has no military to speak of, while the US spends more on military then the next 7 countries put together.   &gt; This is the dumbest statement youve made this entire time.   I have been very patient. I have stuck with this conversation, in spite of the put downs and snide remarks. I have jabbed a little too, but you can go back to most of my remarks and see that I have been more congenial. I have given you some leeway because of your age, and I am almost twice as old as you.   So, you gave me your background. I will give you mine. I am closer to 50 then I would prefer. I left the house at 17, enlisted in the Navy, and spent the next 15 years serving in the military. I ended my career in a select community. I have been out for ten years this July. I am now owner of a company that does R&amp;D and works with the government. A lot of my knowledge about inventions, and how commercial works with government comes from my own personal experiences. I have seen the best, and worst, of government - as well as seen the same on the commercial side of the house. Anyone comes to this game with the presupposition that government can't get anything done as well as commercial quickly learns that is not true. Likeways, anyone comes thinking that commercial equals efficient learns *that* is not always true too.   &gt; Take apple for instance where is all the government funding they recieved to be one of the most innovative companies in human history or microsoft?  As I said previously, that you thought was a ""dumb"" comment - commercial is very good at taking existing systems and finding ways to make them efficient and better. Apple and Microsoft is the same. They both made their mark in history by expanding on and creating innovation with existing technologies that had their foundation in government R&amp;D projects - including the [digital computer](https://en.wikipedia.org/wiki/John_Vincent_Atanasoff), as well as computers like the [ENIAC and the UNIVAC](https://www.computerhope.com/issues/ch000984.htm), and the advancements into [microsecond multitasking](https://arstechnica.com/tech-policy/2011/06/did-ibm-invent-the-personal-computer-answer-no/) which lead to the first efficient and cost effective personal computers. The touchscreen was actually first invented in by [engineers at CERN](https://en.wikipedia.org/wiki/Touchscreen#History). And of course, we know that the [internet started as a government funded project called ARPANET](http://www.history.com/news/ask-history/who-invented-the-internet).   I think you would be surprised how much many if not most of the things we take for granted today have a foundation in government funded R&amp;D. My company is a commercial company, and we do a great job creating our own products and innovation. And yet still, our best selling product is a design of a national laboratory that we license from them. Commercial industry is great at manufacturing and producing, something the government is not as good at, and so often they will license out designs for production to companies like ours. Some of the biggest commercial companies out there do the same." "&gt;We also have the highest expenditures as a percent of GDP than any other nation. Needless to say we spend a LOT on health care also.  That is in large part do to insane healthcare costs passed on to the consumers by the aca. Healthcare spending has increased on average 1.5% annually since 2009 where as the highest growth in spending from 1991 until 2006 was 1.3% (im willing to admit my research may be incomplete or inaccurate here as the available rescources are pretty limited in my short time researching)   &gt;we do have arguably the best health care services in the world... that is mostly only true if you are very wealthy.  Thats a dumb statement leftists make. There is no excuse to not put yourself in debt for the best healthcare possible. Idk about you but I'd rather be in a lot of debt getting first rate healthcare than get affordable care from a 2nd rate community college doctor. Did you also know that medical debt doesnt effect your credit score so even if you ""default"" on medical debts it doesnt effect any part of your life. so why wouldnt you go in debt and then slowly pay off that debt with no fear of negative repercussions for not paying?  &gt;When you break it down on results per dollar spent, the US doesn't even break the top 20. When you break it down on infant mortality, and life expectancy, we have been on a backward slide for a while now (although those rates improved for the short while that the ACA has been in effect, as have the net increase in costs). At the end of the day, the cost of health care has grown 3X faster than inflation, and 20X faster than the average income for over 30 years now. So, no, health care in this country is not the best to the average person.  I dont have health insurance and an ER visit with xrays costs me less out of pocket than 90% of the country why is that? Do you think it has to do with the fact that with the aca hospitals know they are getting paid with 0 questioning on pricing so charge whatever they want and with me they think ""shit this guy might not ever pay us lets just give him a decent price and get some money from him because all we can do is send his bill to collections"" you clearly dont know how the system works especially because you think its my responsibility to provide you with health insurance. You keep saying i need to travel and experience the world when all you need to do is go to google and look at what a wonderful job Switzerland does with their healthcare. The swiss do everything better, They have some of the best services in the world and a very affordable healthcare plan with many options that is affordable to the tax payers unlike the ACA. You have a very clear Scandinavian bias as im assuming you're a bernie supporter who loves democratic socialism despite all of its short comings.  &gt;And yes, Space X has been able to estimate a savings of $300M less... Commercial does a great job of expanding on the research and knowledge that has come from government sponsored R&amp;D. You see that in every modern technological advancement - from the internet, cellular phones, GPS, medical procedures, etc. There are so many modern inventions that have sprung from government patents and government research programs.  This is the dumbest statement youve made this entire time. The notion that inventions that were made on the governments dime (my dime) is somehow the product of the government is asinine at best. Youre operating under the assumption that these inventions wouldnt have been made without government funding which is false. They all would have been made on a smaller budget granted maybe a little bit further down the road but not by much considering technology has expanded (with no help from any government) more in the last 20 years than in the prior 200 because thats what technology does it makes life easier for everyone and almost innovates itself. Take apple for instance where is all the government funding they recieved to be one of the most innovative companies in human history or microsoft? Yiou can max 10 things government funding invented when i can walk into your house and point out 10000 things the government had no hand in at all." I don't see how this is an example of throwing more money at the problem.  I see this as an issue of taking for-profit health insurance providers out of the equation, and making the U.S. government (i.e. the taxpayer) the sole payer for health care services in the United States.  Just like almost every other developed nation does it. "&gt;HOWEVER, any close to normal person can see that there are a whole lot of people with serious issues that nobody mentions to them (or they themselves are afraid to acknowledge) because they don't want to deal with all of the drama.   Doesn't mean they are caused by a ""mental illness"".  &gt;And, just to be clear, the term ""Mental Illness"" in this case(according to the above studies) is really anything from anxiety, to depression, to schizophrenia, personality disorders, and even more social things like compulsive lying. Obviously, the definition is very broad and that is precisely why the statistic(25%) is so shocking.   Just to be clear... that is basically the definition of a ""con operation"".  The term ""mental illness"" (as it is used by the industry) is simply a fraud." Okay fine, great. I think you fail to see my point.  Experiencing someone dying on the table does not alter the reality of what is behind America's relatively high health care costs, and its not an experience that will give one a special insight into the causes of high prices.  Going back to your first point, economists have looked into the exact same cause you proposed. They have weighted its impact on healthcare and its not the largest driving force in way American healthcare costs so much. Ok, so new information, apparently Schizoaffective is automatically qualified for disability. So I guess that changes the question a little bit. We just have to prove she can't adapt well to change, which is evident by the mental break down and severe psychosis symptoms she had after she lost her job.