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Can anyone please explain how this would have worked in the USA, please?

bhsmte

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So a little over a week ago, my wife noticed a new mole on my back that looked suspicious. I made an appointment to see my GP the next morning, he didn't like the look of it either, and referred me to a specialist for an appointment that afternoon, who agreed it looked worrying, took a biopsy and sent it off for pathology. The pathology result was back in 3 days, confirmed displastic nevi, which can become melanoma if left untreated. This morning before work, the specialist performed an excission under local and I'm booked in for a follow up scan in 6 months.

Total time from first concern raised to clinical excission; 10 days

Total out of pocket expense to me for GP consult, Specialist consult, pathology, surgery, and clinical follow up; $0

Had there been a significant cost involved at any point in there, the process may have been significantly delayed, even stopped, which, worst case scenario, could have lead to cancer and death. Instead, with the Australian system, it took 10 days start to finish for best practice standard treatment. I'm genuinely curious to know what the personal costs, time lengths, and flow chart would have been like under the American system, and also what it would be like in the American system without insurance.

Anyone?
The flow (gp doc to specialist) would be exactly the same and the results of biopsy are also just a couple of days. If the biopsy reveals a risk, the mole would also be removed quickly (i have had it done). In regards to cost, it would depend on your specific health plan. Mine cost me about $150.
 
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FenderTL5

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I haven't the words. I'm shocked and appalled, and that doesn't describe it.
I recently had to 're-enroll'. Here is a screen shot (below) of the plan. Note: there are 5 of us in the family - so I am paying for 'family' coverage.

In 2010, there were some differences in the plans but it was essentially the same, except specialists and some tests/procedures (such x-rays) were NOT covered at all. ACA was not yet in full effect.
full
 
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thesopranopiano

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When I was in college, I felt an unusual mole on my back which I hadn't noticed before. Showed it to my mom (who had a history of skin cancer), and she agreed that it looked suspicious, but wasn't sure if it looked cancerous. I wanted to get it checked out anyway, and since I was without insurance, I thought my best bet was the student health center. Gave them a call, and they told me that the doctor who specialized in that was only on campus once every 3 months, and that I had missed him by just a couple weeks. While waiting for when I could make an appointment (couldn't make one that day), I spent the next couple of weeks comparing my mole to pictures of cancerous moles on Google, trying to decide if I should just go to urgent care. It eventually went away, and haven't seen anything like it since. That was over 10 years ago, and I'm hoping I just had a brief case of hypochondria back then.

I didn't lose $100s or $1,000s on diagnosis/treatment, but thought it was different type of example of how situations similar to yours could have happened in the US.
 
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Armoured

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When I was in college, I felt an unusual mole on my back which I hadn't noticed before. Showed it to my mom (who had a history of skin cancer), and she agreed that it looked suspicious, but wasn't sure if it looked cancerous. I wanted to get it checked out anyway, and since I was without insurance, I thought my best bet was the student health center. Gave them a call, and they told me that the doctor who specialized in that was only on campus once every 3 months, and that I had missed him by just a couple weeks. While waiting for when I could make an appointment (couldn't make one that day), I spent the next couple of weeks comparing my mole to pictures of cancerous moles on Google, trying to decide if I should just go to urgent care. It eventually went away, and haven't seen anything like it since. That was over 10 years ago, and I'm hoping I just had a brief case of hypochondria back then.

I didn't lose $100s or $1,000s on diagnosis/treatment, but thought it was different type of example of how situations similar to yours could have happened in the US.
Stay healthy.

I don't think "hoping it goes away by itself" is a health plan I can really get behind.
 
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Greg J.

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There's lots of data online about what costs of medical treatment are without insurance. Here's a comparison with other countries. If a person cannot pay the full amount, I believe that sometimes the hospital will negotiate simply because on average they get more of the payment that way.

But there's plenty of serious illnesses for which the costs can run $15k to $80k up to $250k. But the scary costs are really how seemingly simply things can cost $3k to $8 to $18k OR for illnesses which require lifetime maintenance. I think my insurance company paid about $6k for a cancerous skin lesion I had removed with some of the best methods available (they verified they got all the cancer in within an hour of removing the lesion [before they completely finished the surgery] and the reconstruction was done by a plastic surgeon [who didn't do a perfect job, btw]).

The average American partially lives in a fantasy world and wants better healthcare than they (individually or as a country) can afford and better than is available anywhere in the world, so costs will remain high. There is a lot of fear of death and pain here which impacts all areas of our society.

The United States has the highest healthcare costs in the world per capita and by % of GDP. In 2012, the total cost of healthcare was about 225% of what Australia or England paid. As a % of GDP, #1 U.S. paid about 50% more than the #2 country (The Netherlands). ("Reputable" statistics vary.)
 
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FenderTL5

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Stay healthy.

I don't think "hoping it goes away by itself" is a health plan I can really get behind.
I've heard the 'high deductible, for lower premium' insurance plans referenced in the negative as "Don't get Sick" plans.
a 'Stay Healthy' moniker is only slightly more positive.
 
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trunks2k

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I've heard the 'high deductible, for lower premium' insurance plans referenced in the negative as "Don't get Sick" plans.
a 'Stay Healthy' moniker is only slightly more positive.
I've always heard "Dont get sick" plans as not having any insurance at all.

The high deductile, low premium plan does have its real world uses. I had one as an option from my old employer. I was young and healthy. It was more cost effective for me to set aside the premium savings as a nestegg that I could use in case I did have a serious medical issue since I didn't really need any medical care outside annual checkups at the time.

But that's a very specific situation. I could absorb the high deductible if my bet was wrong.
 
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Armoured

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I've heard the 'high deductible, for lower premium' insurance plans referenced in the negative as "Don't get Sick" plans.
a 'Stay Healthy' moniker is only slightly more positive.
I'm wishing good health to the poster, that's my meaning.
 
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FenderTL5

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I'm wishing good health to the poster, that's my meaning.
Sure - I didn't mean to imply otherwise.

I was merely contrasting your 'Stay Healthy' w/the 'Don't Get Sick' reference that I have heard concerning some plans.
In the end, they both say the same thing, it's just your phrase is much more positive. :)

Also, trunks2k is correct in saying no inursnace at all is sometimes called the 'Don't Get Sick' plan.
However, a high deductible plan is also a no insurance plan unless one is catastrophically ill - which reminds me; the high deductible plans are also called "Catastrophic Coverage" in some circles.
 
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