Advocates of the horrible US health care system never tire of telling us how great it is and one of their favorite targets to adversely compare to the US system is Canada, using the well-worn tactic of finding one or two statistics in which the US has better outcomes to argue that the entire system is superior.
My favorite is when they use the case of hip replacements and point to the longer wait times in Canada to get this procedure done as a reason why we should stick with what we have, But of course, most hip replacements are done on older people who are under Medicare, a US government run single-payer system similar to the Canadian one, so that is really another argument against the wretched employer-based system we have here.
Advocates of the US system love to regale us with anecdotes to hide the fact that the statistics clearly show that the US spends far more for health care than other developed countries but the health outcomes are far worse. So I have started collecting counter-anecdotes and Douglas Coupland provides a doozy.
He tells of his awful experience when he visited the US of being poorly treated for something that should have been easily cured, not to mention being encouraged to take a drug that was expensive and highly addictive. Fortunately he returned in time to Canada where his doctor was horrified at how he had been treated.
And I returned to Canada, where my doctor looked at my prescriptions, puzzled. First, my antibiotic: “Your Florida doctor prescribed you this? [Name drug; get lawsuit.] We used to give this to two-year-olds and, even then, for your body weight, this ought to have been at least three times a day at quadruple strength.”
“OK, but what about oxycodone? You have to admit, it did stop me from coughing.”
“Yes, but you also almost became addicted to a $900-a-pop drug.”
“And just to be clear, you were deliberately underprescribed antibiotics to keep you from getting well so as to ensure that you’d keep going back for more visits and repeat oxy prescriptions. And your doctor was obviously in on some kind of racket with the pharmacist — all that coupon nonsense.”
Within 48 hours, my pneumonia essentially vanished thanks to two azithromycin tablets.
There’s the greatest health care system in the world in action.
If you’re not part of the solution, there’s good money to be made in prolonging the problem.
I don’t believe any of it.
1. You don’t get sick from a cold room.
2. Who would sue him if he named the antibiotic? And for what?
3. Just because the antibiotic has been around for awhile, and just because it is or was used in kids has no bearing on whether or not it was a good choice. (Penicillin, for example--70 years, still using it, and still used in kids)
4. There is no drug product in the US combining oxycodone and a decongestant.
5. Even a month’s supply of brand-name oxycodone does not cost $900, unless one is buying it one the street (usually about $1/mg in my area).
6. Coupons or any similar arrangement for controlled substances are illegal in the United States. And the drug companies have no need to offer coupons on “desireable” drugs such as oxycodone.
7. Even in situations where there ARE coupons for drugs, neither the physician nor the pharmacist profits it by them. Even a quck survey of pharmacist blogs will reveal how much pharmacists hate coupons. The drug companies issue them to persuade patients to insist their insurance pay for the drug, while not having to cough up much of a co-pay themselves. The physicians almost never have any idea how expensive the coupon drugs are (they should, but that’s another story).
8. The doctor deliberately underdosed him to keep him coming back? He would just go see another doctor (which is what he actually did do).
This whole story sounds like the kind of quasi-paranoid stuff I hear every so often from people who have no idea how the healthcare system works, and it says more about them and their morality than it does about their bizarro version of the US system. I have been in health care for 40 years, first as a pharmacist, then as a physician; a lot about the system is despicable, a lot would be laughable for it ineptness and stupidity if it weren’t ruining some peoples’s lives and failing others outright, but attacking it on the basis of a story that doesn’t hold water is not going to help.
My employer just went to a wonderful new healthcare system wherein we pay $1000/month (for family coverage), which gets us…the opportunity to meet a $5k/year deductible…in other words, the insurance will not chip in a cent for the year until the insured has paid out $5k.
But wait, it gets better! We can’t just pay the money and be done--oh, no, we get a middleman--a company headquartered in Florida (naturally) who oversees how we spend our money to decide whether or not it qualifies toward the deductible.
Right before Christmas, I had a child with a fever and sore throat. Off to the doctor we went, where an in-office quick-strep test diagnosed strep throat. Antibiotics were prescribed and paid for, and in a couple of days, the strep throat went away and my credit card limit was reduced by about $300.
I dutifully sent all my my paperwork to Florida, got the rejection notice, sent them again, got a warning that the doctor visit wouldn’t be covered until I submitted my paperwork, submitted my paperwork AGAIN…and was denied, because the doctor visit I just described “does not count” as “qualifying medical care”. I’m fighting that now. So far to date, I’ve spent about nine hours (mostly on hold) on the phone arguing with various administrators and faxing and re-faxing personal information to who-knows-where.
Yup, we Americans have the best healthcare in the world!
Mano Singham says
You might be interested (or depressed) in reading about my own experience three years ago trying to deal with the whole business of insurance for what should have been a routine process. I wrote a four-part series that you can read here, here, here, and here.
Katydid, try calling your state’s insurance administration or your state’s attorney general. Years ago, I had problems with an insurance co. I sent a complaint to the insurance commissioner and it was all resolved. Each state is different of course but it may work. Unfortunately, the medical insurance system is beyond ridiculous but no politician has the guts to take them on
Karmacat, thank you so much for the advice (no sarcasm at all). I called the AG, who told me there was nothing that could be done about it.
The problem is two-fold: 1) a $5k deductible on top of a $1k/month premium, 2) a middleman in a far-off state that is NOT a medical entity, but instead a pure, profit-making entity whose interest lies in holding onto each insured person’s $5k as long as they can.
In order to get justice, I would have to report them to Florida’s AG (are you laughing yet? Florida is the land of the grifter) and get Florida’s AG to work with my state’s AG to resolve this.
I’ve been interviewing and have accepted a job offer with a different company specifically because it does not have this middleman. Now I just have to fight with the Florida company to get my $5k back for 2015. Should be a cakewalk, no?
Mano, thank you for those links. I had no idea FTB existed in 2011 so this is the first time I read your story. I can believe it. I have lived it (not those exact tests).
In contrast: right out of college, I went to work in England for an American company (I am a native-born American). The pay was awful and there were no medical or dental benefits. Before I left the USA, I knew from my own dentist that I needed to have my wisdom teeth pulled. I couldn’t afford it in the USA, either--the estimated cost to pull them all was $2500, which is an impossible sum if you make $10/hr. Shortly after arriving in England and while chatting with my new neighbors, talk turned to dental care and I mentioned my situation. My British neighbors were aghast and insisted I go to the local dentist and tell him my story. I did, and the dentist offered to examine me. When I explained I was not a British citizen, he said he got paid a salary, not by procedure. He pulled my teeth and sent me on my way.
Just a couple of years ago, while on business in Holland, I agreed to spend the weekend with my Dutch client and his wife and kids at a holiday location (we had known each other for years so it’s not as sketchy as it sounds). As we were hauling the luggage into the house, one of the kids fell off the porch and seriously injured her leg. In the USA, this would be a disaster. My Dutch friends calmly called the local clinic, and since none of us knew quite how to find it, a doctor offered to come to us with a portable x-ray if we could wait a half-hour. (My note--a half-hour? I’ve spent 11 hours in the ER with a convulsing, delirious infant!) The doctor showed up with her own infant, and we watched the baby while she x-rayed my client’s daughter. The injury was a really bad sprain, not a break, so she bandaged it up and handed over some pills for pain. When I asked about the cost, my client laughed and said, “That’s what insurance is for.” They pay a fraction of what I pay, and when they need medical care…they get it.
I haven’t had a bad insurance experience, but I have had a bad healthcare-for-profit experience.
I had a lodged kidney stone. The stone didn’t show up on my x-ray, but using that x-ray, the doctor signed me up for a procedure that required it to be visible on x-ray (lithotripsy). On the day of the procedure, after I had been prepped and drugged, they dutifully informed me that the stone could not be seen on x-ray. So they took another x-ray and then told me the procedure was cancelled. This required me to make another appointment (with associated fees) to be scheduled for a different procedure. Some weeks I received later I received the bill for the cancelled lithotripsy--$2000 for use of the hospital bed (the majority of the charge), a bag of fluid, a generic sedative, and the x-ray (my part after insurance was $200). I appealed since the procedure clearly never should have been scheduled, but I didn’t win and now the hospital is threatening collections.
When I did have the stone removed, they inserted a pig-tailed stent. I had requested a stringed stent so I could remove it myself when the time came (after reviewing the literature, I learned stringed stents were found to be just as safe and effective and maybe somewhat less painful to remove), but they ignored my request. So I had to go back to get the stent removed in the office via cystoscopy (again, as an assault survivor, I’m unusually uncomfortable needlessly spreading my legs for strangers), to the tune of $1000 (my part was $250). They also removed the stent several days too early because my insurance was going to expire.
Not to mention, I’m still making payments on the $10,000 bill for the actual stone removal. I do think if I hadn’t had insurance, I might have lost my kidney (or died?), because it was severely, painfully swollen due to the blockage. So I’m pretty lucky in that regard.
“My note–a half-hour? I’ve spent 11 hours in the ER with a convulsing, delirious infant!”
No kidding! I always roll my eyes when people claim the US healthcare system works so fast due to the profit motive, compared to those overflowing clinics in “evil socialist” countries where wait times allegedly reach into the months. With my kidney stone, I had to wait two months to get my procedure done, even though my kidney was blocked off and swelling!
I also wanted to commiserate with the deductible issue. These high deductible insurance plans are basically useless to many families, because after the premiums and deductibles are accounted for, the family must spend well over half its income before it sees a single benefit! A grand a month with a $5,000 deductible (or $10,000, as my spouse’s employer “offers”) means a family must fork up $17,000-$22,000--the equivalent of an annual salary for a low-wage worker--in cash before insurance kicks in. And we’re not even factoring in co-pays and co-insurance…
Mano Singham says
Your kidney stone experience is emblematic of what is wrong with the system. I am sorry that you had to go through all that.
Mano Singham says
I do not think that you have to be a citizen of the UK to get NHS service. As long as you are a resident and paying taxes you are eligible. At least that used to be the case. I know because I had two major surgeries in the UK as a child and it was all free because we were living in the UK while my father worked at the London branch of the Bank of Ceylon and was a UK taxpayer.
I really like the kind of informal medical system that you describe in Holland. It is only possible when you don’t have a massive insurance industry acting as gatekeeper. The show Doc Martin that I reviewed in another post shows how it should work.
@carbonfox; in addition to the outrageous deductible and insurance, most families will simply not spend $17k or greater in healthcare in a typical year, ensuring that the insurance (see what I did there?) will never have to kick in.
If I took $1k/month and put it in my bank account, that would get me $12k/year (plus whatever piddly amount of interest it might earn). If I then used that money to pay in cash in full for doctor appointments, I would come out ahead. Excepting the $300 case of strep, nobody else in my family needed a doctor all year. That’s $12k (plus interest) the insurance company got to keep, and $4700 (plus interest) the for-profit connect-your-care scammers got to keep.
@Mano; when I lived in the UK, I was still a US citizen paying US taxes (I believe you have to have a minimum residency of a few years before you can be considered tax-free in the USA). Nonetheless, I was treated by an NHS dentist and I got excellent care with no complaints. I remember the tabloids in England in the late 1980s carrying on about outrageous wait times for procedures. I’ve revealed elsewhere what I’m paying, and I have outrageous wait times for healthcare in the USA.
More anecdata; a few years back, I discovered a yellow-jacket nest in the backyard. I escaped into the house with 31 stingers in my legs, arms, and face. Not sure if I was allergic and not sure what that many stings might do to me, I called my doctor’s office and was informed there was a 6-week wait for the “next open appointment”. My insurance at that time required preauthorization for a trip to the ER, so I called and was put in a queue where I was eventually told to leave my name and number for a callback. The callback came SEVENTEEN HOURS LATER, when a nurse from another state told me to GO GO GO to the ER as fast as I could. Well, by that time, if it had been urgent, I would have been dead.
Mano Singham says
“preauthorization for a trip to the ER”? What a bizarre system!