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submitted 1 year ago by alcasa@lemmy.sdf.org to c/asklemmy@lemmy.ml

Not on a theoretical level, but how would you practically have to pay costs, access specialist doctors?

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[-] RBWells@lemmy.world 16 points 1 year ago

U.S.A., I have a "high deductible PPO" plan, more or less what my parents would have called "Major Medical".

It covers only some preventative care, for $0 out of pocket, whatever is mandated by the government basically so annual wellness, annual woman-care, birth control, one dermatologist visit.

Then nothing, until we spend some ridiculous amount in one year, I think it's $7,000? At which point it starts paying 80% until we have paid an even bigger $, then it pays 100%.

So we don't have healthcare, exactly, we have limited liability for healthcare cost.

Specialist I can just schedule, do not need to be referred by GP. Prescriptions are subject to that same high deductible.

This plan costs, out of my paycheck, kind of a lot for family coverage, and employer puts back some of it onto a "health savings account" that can be used to pay towards the cost. Not anywhere near that $7k but some, and what is not used stays in there. I also put money in that account out of my paycheck to build it up so that when we do eventually have a bad year again, the money will hopefully be there to use.

Yes it's complicated.

[-] Ultraviolet@lemmy.world 2 points 1 year ago

This is the plan the vast majority of people in the US have. It's dogshit.

[-] RBWells@lemmy.world 3 points 1 year ago

Yes it is. And besides the premium and other costs, we also pay taxes for care for the sickest and the oldest. These private insurers are cherry-picking the group they insure and still charging the outrageous fees, raking in profit and outsourcing the more expensive groups to the rest of us to pay for. So I get about half of my paycheck as netpay after medical, tax, HSA and 401k; same as someone in a socialized nation, but without the assurance of healthcare or a pension.

this post was submitted on 30 Sep 2023
119 points (96.9% liked)

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