Hey all, I’m British so I don’t really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.
So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.
However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals. If you don’t have insurance, the cost is lower or removed entirely. Supposedly.
So I’m just asking… How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.
How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?
On average they actually spend $12.500 per year (total, PPP adjusted, at leat that’s the number for 2022)
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
You as a Brit spend $5.500 (also adjusted) (And as a bonus, at the same time you’re also expected to live 2.8 years longer than the average American.)
Plus the Brit coverage is universal while the US has a significant number of uninsured. We pay double on average including for those that aren’t covered at all. Even though the long lines myths are overblown for countries with universal care, it is important to remember that in the US a lot of people never get the care and we still have massively long wait lines unless we can afford to be first in line. The wealthy have a fast pass.
This is really important for non-Americans to understand. Yeah there are waits to see specialists and so forth in countries with a public system. We also have waits…but it’s for people who can’t afford the procedure. They have to wait until they can afford it, and if they can’t they simply have to live with their condition indefinitely or until it’s bad enough that they go to the emergency room. People who are uninsured go to the emergency room for everything because, legally speaking, they can’t turn you away. They have to at least diagnose and stabilize you. Because these people are broke, they generally end up not paying the bill, which means everyone else’s costs go up.
You couldn’t devise a worse system if you tried.
Eh, on average that may be true. But most people pay far less than that. The NHS’s budget is £153bn, and the government raises £950bn in revenue. Of the 950bn, around 25% is from income tax.
So by that logic, the amount of my income tax that goes to the NHS is about 0.25*153/950 = 4.0%. Last year I paid £6644 in income tax, so that’s about £265 to the NHS. I’m not counting National Insurance as those contributions are not for the NHS.
VAT is also 15% of government revenue, so if I wildly guess that I bought £10k worth of “stuff” last year then that’s £2000 in VAT (@ 20% - it’s not all necessarily 20% but to simplify), of which £300 went to the NHS.
So I’m still not even paying £600/year. There are some other small contributions that you could count, but it’s not going to make much difference to the final figure. I’m far from rich but I’m more well-off than most people, so the majority of citizens are paying less than me.
What I’m saying is, for most citizens we actually pay relatively little and get huge value out of the NHS. The rich pay proportionally a lot more, which is how it should be.
( http://assets.ce.columbia.edu/pdf/actu/actu-uk.pdf )
So it should be more like £1.200 for you?!
And I think the study I linked is total healthcare expenditure. So it also covers the extra private insurance and the medication you buy that isn’t covered at all. I’m not 100% sure.
But yeah, that’s how statistics works. For everyone who pays less than the average, there has to be someone who pays more than the average. And I also think it should work with solidarity. Rich people can afford to pay more.
I spend more than that just for insurance for two. Actually using it costs far more. Strep? $250. Video call a random person when I’m in bed after puking my brains out? $100 for a five minute call where they tell me to drink water. Minor surgery? Thousands of dollars in bills sent between two months and two years after the surgery.
I really wish you people that it’ll become better one day. It’s just a rip-off and and a way to funnel money from normal people to the rich. Looking at other countries, you could do away with the scary bills. And on top have an extra free $5.000 each year. Per person. And I think it’s extra cruel to rip off people with their health.