[rakmos]

This hits home for me.. my son (now 4 years old) was born very premature at 29 weeks and some change. He spent 7 weeks and 4 days in the NICU. The total hospital bill that was charged to insurance (before settling it between themselves) was roughly 960_000$.

If you include the additional services and whatnot in the few months following being discharged from the hospital he was a million dollar baby.

Complete insanity frankly.. few things make my blood boil more than the sad state of health insurance in the US. Sure, it has gotten better since the ACA… but there is soo much more that needs to change.

[inglor]

In Israel we have public healthcare. I was born at week 32 and spent about 6 weeks in the NICU - everything was free.

It's not always great and I do pay for private insurance in case I need something urgent - but everything emergency is absolutely covered.

I believe it's this state in most developed places that are not the US?

[cloverich]

It depends quite a bit on what happens in that NICU. Our daughter was 32 as well and had a relatively uneventful stay. Same for many other infants. Our (insurance) bill was ~30-40k and out of pocket was minimal. Other's were not so lucky, having all manner of procedures including bowel resections / repair, heart surgery, etc. Many things look routine but I can assure you pediatric heart surgery is anything but.

So, not to defend the (out of control) prices, but only to say no two NICU stays are exactly alike. We can run the gamut from "a nurse could handle 100% of their care" to "we need 4 different specialists with decades of experience each to keep this person alive" and the costs fluctuate accordingly.

[refurb]

It was free to you, but not the system. NICU is very expensive even outside the US, you’re talking several thousand a day. So 6 weeks could run $100,000+ easily.

[101008]

Same in Argentina.

[wonderwonder]

freedom isn't free! /s

[markoman]

Going bankrupt on a hospital bill isn't freedom, either.

[CountDrewku]

Everything was not free, you just didn't pay directly for it while you were at the hospital.

I don't understand why the word free always gets thrown around for country's with socialized medicine. You are paying for it.

[simonh]

The marginal cost to the patient for having that treatment was zero.

Meanwhile in the US the federal government spends 8% of GDP in tax payer funds on health care, for things like Medicare, Medicaid, CHIP, etc. That's the same as the UK pays for health care, counting public and private expenditure combined. You are already paying the cost of an entire first world health care system in your federal taxes, and as an employee you and your company also still have to pay for your own private health care to actually get any treatment for yourself.

[marcyb5st]

Yes, we are paying for it, but given that governments negotiate prices for 100% of the population you get much better deals. Also, looking at taxation rates in the USA [1] vs. Europe [2] I don't see a difference big enough to justify the need for privatizing healthcare.

Furthermore, considering the Europeans also get basically free higher education (I payed around 20USD every 3 months to get my CS degree) I believe people living in the US got a far worse deal.

Finally, I don't blame US citizens as I have many colleagues and friends from across the pond, but I don't understand how you guys can tolerate the practice of "lobbying", which is what created your healthcare system.

[1] https://en.wikipedia.org/wiki/Taxation_in_the_United_States

[2] https://en.wikipedia.org/wiki/Tax_rates_in_Europe#/media/Fil...

[runjake]

You don’t need to explain this. Everyone knows how “socialized medicine” works.

What they are saying is that it was zero out-of-pocket as opposed to a quarter of a million dollar bill.

[CountDrewku]

Cool well since we're going with that logic I'll just go ahead and say my insurance provide through work is free.

[lostcolony]

Nothing is free. Even if no money exchanged hands, someone put in some time and effort, which has a cost, even if it was just going and picking an apple for themselves to eat, from their own tree.

Pointing that out isn't helpful; it's not relevant to the point at hand, and everyone knows there is still a cost.

[xtracto]

This American fixation with the word "free" always makes me chuckle. Aa when a bus driver in Las Vegas got angry when I asked them if thag was the "free" bus, and he angrily replied "it's not free, its complimentary " .

[CountDrewku]

Ok then I assume that using the word free for the insurance I receive from my job is just fine?

[gruez]

Is this a copy pasta? I see this exact story repeated in several sites/comment threads.

[xtracto]

Maybe you saw it on a previous story where I shared it as well? If you look through my comments you'll find it. Albeit a bit more expanded I think. Sorry if this bothered you.

[Cthulhu_]

True, but that said, rates in US hospitals are massively over-inflated. They get away with it, insurance companies are not pressuring enough to lower cost (they're probably in on it), and there is no real competition.

[CountDrewku]

I don't disagree I just dislike the dishonesty being presented. The word free is used to make it seem much more palatable to put in universal healthcare and they know it. The reality is there are downsides to having universal healthcare.

[Symbiote]

Most roads in the USA are also "free", as are the police, etc. Healthcare elsewhere may be similar.

[CountDrewku]

I've never once gone around calling police or roads free, nor have I heard anyone else do this.

[dbspin]

Because mental funds are non-fungible. Amortising health costs through progressive income tax helps a) keep overall costs down, as the state centrally organises the health system / collectively negotiates with providers and b) is more fair. It doesn't feel like you're being utterly screwed through no fault of your own - e.g.: medical bill after an accident or violent attack. Instead society at large acknowledges two things a) we all need medical care and b) our need is largely disconnected from our capacity to pay.

[arethuza]

Free in this context clearly means "free at the point of delivery" - we all know we pay for it in our taxes.

[craftinator]

But in the case of the US, we pay for healthcare in our taxes, pay again as companies, and again pay co-pays as individuals.

[arethuza]

I think I'd find the uncertainty that seem inherent in your system completely terrifying - its bad enough being sick but then to not know what that would cost seems crazy.

I can't help thinking of the book title by Aneurin Bevan, founder of the UK NHS: "In Place of Fear":

https://www.goodreads.com/book/show/2042463.In_Place_of_Fear

https://en.wikipedia.org/wiki/Aneurin_Bevan

[craftinator]

Yes, the uncertainty is by far the worst part. I personally won't seek medical help unless I am completely sure I have a problem I can't handle myself (which will likely get me killed eventually, but at least my family will be able to pay for the funeral). A large part of that is not having any way to pre-budget the cost. If I don't know for sure I have a problem I can't deal with, I could go through thousands of dollars worth of testing only to find that it's acid reflux. And at that point the reflux would become worse because I'll develop ulcers just thinking of the debt.

[eatplayrove]

In addition to the other replies to you: almost nobody pays $960k in taxes, but they still get this benefit.

[CountDrewku]

Almost no one pays 960k in hospital bills either. That's an insurance negotiating price not what the patient sees.

[wil421]

The billing system is a complete farce. Here’s a large made up number for the total bill, ok here’s another large number because we like your insurance, and finally here’s what your insurance actually paid.

My wife had complications the first time and the total bill was like $35k, insurance paid $9k, and our cost was $0. We actually got our $250 admission back.

Nobody pays the made of number from the first bill not even the uninsured.

[spaetzleesser]

“Nobody pays the made of number from the first bill not even the uninsured.”

This is maybe true but the actual number you pay is a total gamble depending on whatever the hospital feels like they can discount this month, whatever loopholes the insurance has found for not paying, whatever hoops the insurance or hospital have set up and you have jumped through correctly or not and how much time you have for the next few months or years to fight the bill.

It’s a totally insane and arbitrary system. Probably the pinnacle of a large and unaccountable bureaucracy. Sometimes I wonder if dealing with the mob is a more straightforward and reliable thing vs going to a hospital.

[jrs235]

>It’s a totally insane and arbitrary system.

And therefore it's always a gamble of whether one should go in and causes many to not go when they should because "is this really worth we potentially having a thousand plus dollar bill?"

[spaetzleesser]

That’s my position. Especially with deductibles I am very hesitant to go to a doctor. Is it really worth $3000 deductible plus other unknowable cost to have something checked out?

[wonderwonder]

Sure, but if they stress you out enough with the made up numbers you will be a return customer sooner than you would like.

[yunohn]

> he was a million dollar baby

Imagine the life you could setup for a child, with a million dollars to start off with. Instead, it just lines the pockets of the corrupt healthcare industry.

[weavie]

Wow. My daughter was born at 25 weeks and spend 4 months and 1 day in NICU, just over 10 years ago. This was in the UK. If my memory serves me correctly (which it may not, my brain was pretty fried throughout that time), we were told that the total cost to the NHS was roughly 150,000 GBP.

[enriquec]

By what metric have things gotten better since the ACA?

[enragedcacti]

Here are a number of metrics that have improved since the ACA.

- percent uninsured decreased

- number of people skipping treatment for cost reasons decreased

- number of people with "pre-existing conditions" covered increased

- satisfaction with coverage increased

- growth of healthcare costs slowed

Not to mention other provisions that are broadly popular such as children being allowed to stay on their parents health insurance through the age of 26 and mandates that require all plans to cover basic services.

https://www.cbpp.org/research/health/chart-book-accomplishme...

[ceejayoz]

One very clear one: Access to insurance for folks with expensive preexisting conditions.

[rakmos]

Well for one, my son could be labelled as having a pre-existing condition as a result of the premature birth.

[wilde]

Medical bankruptcies.

https://www.colorado.edu/today/2020/04/30/affordable-care-ac...

[zikduruqe]

I filed for bankruptcy about 10 years ago due to a family member's medical bills. Funny, a year afterwards, when establishing credit again, all the financial institutions were like "yep, no problem, it happens".

24 months later, credit was back to normal-ish, bought new car, financed new home, and no medical debt.

[hermannj314]

I believe ACA was originally meant to be even stronger, with a universal option and that was opposed.

I agree with you that we should revisit and strengthen ACA and add that component back in.

[swashboon]

availability, coverage, cost

[dexterdog]

Um, not cost.

[only_as_i_fall]

Depends on who you ask. Before Obamacare if your employer didn't pick a great insurance plan and you got seriously sick the insurance could cut you off after you hit a lifetime maximum and then future policies wouldn't cover that specific condition because it was considered pre-existing.

This happened to my parents in the 90s and we went through multiple lifetime maximums and had to pay hundreds of thousands of dollars over the course of 10 years.

Obamacare is great for making health insurance actually act like insurance.

[aksss]

People on individual market with no subsidies (making over, say $50k) got absolutely raped by the ACA. It's great that many uninsured got insurance, but many people like myself spent years uninsured post-ACA because the cost was higher than a mortgage payment with absolutely zero realized benefit until the massively high deductible was met. People who couldn't afford this were then charged thousands by the IRS as a penalty with zero benefit. I find myself not a fan of it from a policy perspective. Didn't like the way it was passed, written, or implemented. Some good effects, but truly bad effects as well. Scrapping the mandate was beneficial for people in my position (starting businesses), but still the healthcare system in the US is a train wreck. It's neither a free market system nor a public system. It is fundamentally broken unless you are an employee of a larger corporation that offers benefits.

[spaetzleesser]

Yeah, they forgot the cost part. It probably didn’t help that the republicans did whatever they could do to kill ACA instead of trying to improve it.

[hungryforcodes]

That's insane. At most it would have cost just a few thousand in many countries in Asia with comparable medical competencies. So is there a new strategy of going to non-western countries to deliver babies and have expensive surgeries?

Of course I don't need to mention that in Canada and most countries in Europe this wouldn't have even been an issue. That would be pedantic. /s

[carschno]

Not entirely true any more, unfortunately. Many (Western) Europeans go to countries like Poland, Hungary, Turkey for treatments that are typically not (fully) covered by health insurances, like manydental or laser eye surgery.

There are private clinics specialized on Western European patient with staff speaking fluent English, German etc.

[tomwojcik]

Pole here. Recently my friend gave birth at 27 weeks to two boys, 700g (1.5 pound) each. Premature newborns spent over 3 months in the hospital (pediatric ICU), were unable to breathe by themselves. Parents got vaccinated in January against corona and the official "early birds" vaccination process for the population started about 3 months later (for public service). Everything was free of charge. I can't imagine having to pay for a visit in the hospital.

EDIT: Also, I know a guy from Denmark who flies to Poland just to fix his teeth.

[jhot]

Same. My wife gave birth last year at 26 weeks. 3 months in the NICU was over $1MM and that doesn't even include the delivery. We were extremely fortunate that my wife works and has good insurance because I had just been laid off a couple weeks prior. We were big proponents of a medicare-for-all-like system before all that, and even bigger proponents now.