[deisner]

"But none of these is her most gnawing, ever present concern.

That would be the convoluted medical bills that fill multiple binders, depleted savings accounts that destroy early retirement plans and so, so many phone calls with insurers and medical providers."

Is it like this in other OECD countries? I ask because I'm told that we in America have "the best health care system in the world."

[gambiting]

My father fought cancer for the last 8 years of his life, and was on 2 boxes of Glivec a month for all those years(in US Glivec treatment costs about $146,000/year[0]). He also had 2 operations to remove some tumors, plus bi-monthly MRI to check if the cancer came back. He has never paid a single penny towards the treatment. In fact, the hospital would always reimburse him for taking the train every month to get his drugs and check-ups done. There were no bills to pay, I think he only had to sign one piece of paper every month to say that he picked up his medicine and we could go home. There were never any calls to any insurers or medical providers, simply because as patient over here you don't care who is paying for the treatment. You turn up to the hospital for whatever treatment is planned and that's about it. You don't even know how much the hospital is paying and to whom. It doesn't even matter if you are currently employed/unemployed and if you're paying towards the national health service - if you are not employed(say as a result of your illness) you are still 100% covered anyway.

After he passed away(the cancer unfortunately came back and not much could have been done at that point) his savings account was definitely not affected by 8 years of illness.

That's in Poland btw.

[0] http://www.ascopost.com/issues/may-25-2016/the-arrival-of-ge...

[mikestew]

I ask because I'm told that we in America have "the best health care system in the world."

I'm going to assume that you're asking an honest question, but I'll tell ya that (and I can not emphasize this enough) from my perspective the question is so naive that I seriously think I'm missing the sarcasm.

But in good faith I shall carry on...AFAICT, "US=='best'" is propaganda, or ignorance at best. We (I am an American) have poorer outcomes for more money spent. Now, many excuses will be offered as to why that is, but I'm not here to argue; as best as my research can do, that appears to be fact. On top of that, for a less capable and more expensive product, we have a byzantine system of forms and providers.

So, no, it would appear that other OECD countries do not have this issue, partly/mainly because all but a few (and I would be hard-pressed to name those few) socialize their medical care.

[lotsofpulp]

No, my family in Canada and UK don't deal with any of this. In the US, it's not even worth your time figuring out how much your treatment will cost, other than whether or not the provider is in network or not. Assume it's the out of pocket maximum for your insurance, because when you go to a provider, you sign a blank check that says you will be responsible for whatever chargers they make up during the course of your treatment. So your only ally is the insurance company, who has the power to deny payment for things like $15 worth of linens (which was actually a few pieces of paper towel).

[maxxxxx]

" whatever charges they make up during the course of your treatment"

That's the worst. Pricing is totally arbitrary. You may spend 5000 or 100000 for the same thing and there is no way to know upfront.

[shereadsthenews]

You can't figure out whether your provider is in or out. Just yesterday I got a bill from someone I've never heard of who turns out to be a "Medication Safety Specialist" who allegedly rendered services to me worth $392. You'd think such a person would just be a functionary of the hospital who in any case bill me $27k every day, but actually they are some kind of mercenary who bill patients directly.

[lotsofpulp]

Yes, it's crazy how difficult these little things are.

During birth, should one stand outside their wife's delivery room and ask each provider to wait outside while you look up if they are in network or not on your insurance company's app? At least we have apps to do that nowadays.

[shereadsthenews]

Yes, you should. When my wife gave birth the first time there was an endless parade of idiots who uselessly entered the room for a moment and then left and later sent a huge bill. We also got a bill from the anesthesiologist who was not present because my wife didn't want it and for the supposed attending obstetrician who, although they were paged, never showed up. We had to go through disputes of all those things and even though we prevailed on all of them, my attorney had to get paid.

[lotsofpulp]

I would definitely recommend actually doing that, but I kind of meant "should we do that" in a sense of "should we be behaving like this in a civilized society"?

[lars512]

No, this side of it is definitely better in other countries.

My late wife passed away of cancer a few years ago, we lived in Australia. She went through rounds of intensive treatment. We had private health insurance which kicked in, limiting our up-front costs. Not all was covered, but what wasn't covered was capped through public health care. It might have cost us $10k AUD, but not more.

We spent little to no time worrying about paperwork and billing, it was almost all auto-handled for us.

[Xixi]

The administrative/insurance side of American healthcare is probably one of the worst, if not the worst in the developed world. But the quality of the care itself (the actual treatments) is very high, probably one of the very best. I think the American health care is especially good in terms of treatment availability: many drugs are simply not available in other countries (or are available but not covered).

Some people are genuinely concerned than touching the former (administrative side) will result in lowering the level of the latter (quality/availability of care, drugs, etc.). That it's the inherent high cost of the current US system that somehow makes it so good in terms of availability/quality of care. I disagree, but can somehow understand the line of thought.

EDIT: I have no idea to what extent care is really better in the US than elsewhere, but know first hand of someone who had to pay for interferon out of pocket in Japan because it was not yet covered at that time. It's not rare for the newest US drugs to take many years to cross the Pacific ocean...

[Sharlin]

No, it is definitely not. Whoever tells you that is either lying, ignorant, or in denial.

[deisner]

My question was slightly sarcastic, but primarily sincere, in that I want to hear first-hand accounts from cancer patients in other OECD countries.

Rudy Guliani said this in a campaign ad [1] when he was running for U.S. president in 2007-2008. I also recall him saying this in one of the Republican debates. When my (now) wife, who is German and has also lived in Denmark, heard this she couldn't help laughing.

[1] https://www.cbsnews.com/news/giuliani-ad-chances/