Thursday, November 06, 2008

Paying for Medicine

One of the interesting things to come out of the campaign debates was a tangible fear among Republicans of 'Socialized Medicine'. Of course, to me this seems completely back to front - I had been assuming that Americans unanimously wished they could be like almost all of the rest of the civilized world and receive free public healthcare. To me, the concept of having to pay was totally alien and rather offensive at first. But now that I've had a few experiences with the American health system, I'm beginning to understand the argument a little better.
My first encounter was almost totally negative. I took a trip to the ER, which turned out to be completely unnecessary, but cost me $150. Luckily they never billed me for the Ambulance ride. But this event highlights two of the biggest problems in my mind with how the system works.
Firstly, treatment is not offered conditionally based on price. That is, you're never asked "Would you like this treatment (it will be $100)?". It is assumed that you want whatever treatment is best for you, and that you will pay with bill no matter the amount. Where else do middle class people make choices on those terms. At a restaurant, you decide whether to order the lobster partly based on the price of the dish.
Secondly, if you have insurance, you know they're trying to screw you somehow. It is virtually impossible to tell what you'll have to pay for until they send you the bill.
I was also very disappointed by the level of service at the ER. They weren't busy, and I guess I felt that since I was paying to be here, I should be treated like a hotel guest!

Anyway, my recent trip to the doctor was much more positive. Don't worry, there's nothing wrong with me! But it's about time I began regular check-ups, and I've been putting it off simply because I had no idea where to begin. In England, it seems so simple. You find you nearest GP, and go there. But here you have this wonderful thing called choice, which makes things impossibly complicated. Again, there is so much information out there, but so little of it is made readily available to the 'consumer', so having to make an educated choice is a complete headache. In the end, I discovered the secret shortcut: Ask someone at work who their doctor is - then you know that you'll be covered by insurance and you get a personal recommendation.

Going to the Doctor (by contrast to the ER) seemed like the deal of the century! For $25 I got one-to-one attention. When I go back for a 45 minute physical exam, again it's just $25! The people are friendly, and I felt like i was being treated with the respect that a paying customer deserves. I think the euphoria is mostly relief of knowing that I have somewhere to go now if I fall seriously ill. And really, the healthcare is only cheap so long as your healthy! Once you need regular treatment, it quickly become a whole different story. Perhaps it's good, as it encourages preventative measures.

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