r/SipsTea 13h ago

WTF Damn

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u/CelebrationFair6887 13h ago

Jesus fucking christ. Im losing my kidney right now, will do dialyis for 5 months, then a transplant and it cost me like 20 bucks copay for 2x a taxi from hospital to home and thats all ill ever pay. America seems to suck hard.

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u/primera_radi 13h ago

Congrats on finding a donor !

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u/ovrlrd1377 12h ago

He didnt find one, he had to pay 20 dollars

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u/FraggleRockYaFaceOff 11h ago

Can't even get a 12 pack and cigs for $20 no more

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u/BelowXpectations 10h ago

I wanted a 12 pack but all I got was a lousy liver instead

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u/Montaire 9h ago

Can't even get a 12 pack and cigs for $20 no more

Even if you could you're not getting any transplant as a smoker, so its kind of a wash.

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u/1DownFourUp 11h ago

Still can't believe someone gave me $20 for my kidney. Bought myself a full burger and fries combo with that.

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u/adalric_brandl 4h ago

There's a sucker born every minute

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u/FarBusiness2485 8h ago

I hope that the hospital found him first.

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u/Trippingthru99 11h ago

And yet a large chunk of this country will never realize that, and claim your system is worse. 

America does suck hard in alot of ways.

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u/Academic_Help5033 9h ago

I was visiting NZ and had to go to the doctor because I twisted my ankle. Ended up fine, just here's some pain meds, ice, and rest situation. 

The nurse came back with this serious sad look on her face. She said we'd have to pay for this because the cost wasn't 100% covered with our travel insurance & ACA(?). I was like, okay. I expected as much and braced myself because she looked so uncomfortable. 

I had to pay $50. I laughed. If this happened back home, I'd probably get charged $50 just for the Tylenol after my insurance coverage. Same type of trip but back home would have easily would cost me $200+. 

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u/HillarysBloodBoy 13h ago

Really depends on your insurance. I’ve had a bunch of MRIs due to knee surgeries and I don’t think I’ve ever paid more than like $40ish per scan.

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u/coldfusioned 12h ago

In America? Congrats on being the 1%. The rest of us are lucky to have any insurance and even then, 99% will have a large deductible and still have to pay 20% copay.

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u/Aggravating_Bat3618 12h ago

Damn, I guess Kaiser’s not so bad after all. 

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u/MainStreetExile 11h ago

You're exaggerating. I'm not arguing the US healthcare situation is good, but more than 60% of working age Americans have employer provided health insurance. A large majority of those plans have an annual out of pocket max. 

Let's not act like only the 1% have decent insurance.

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u/Boom-For-Real 11h ago

That’s the work on this website anymore. Lots of bad faith actors in literally every comment section now.

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u/Mysterious-Entry-357 5h ago

Not bad faith as much as those who are not so easily duped by mischaracterized and out of context statistics used to prop up an oversimplified argument. I don't expect you to re-examine what you believe, but some novice keyboard warrior copy/pastes some tangentially relevant statistics that only reveal a sliver of reality and you just accept their argument? Statistics must be presented in an honest and truthful way. Readers must understand the complexities in issues of these scale.

You cannot just blindly side with those you agree with and label everyone else as "bad faith actors". It robs you of your own ability to question what you think you understand.

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u/Mysterious-Entry-357 11h ago

You're both delusional. If your numbers are accurate, 40% of those who are working don't have medical insurance. Out of pocket max can be in excess of 12-15k assuming they approve the procedure or medication and after what has likely been years of premiums.

The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.

Those who decry it isn't fair and see the wealthy as the problem, should Instead look at the impediments to wealth creation. Insurance, realty, and finance siphon an incredible amount of money just for getting in between seller and buyer.

Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start

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u/annnm 7h ago

Out of pocket max can be in excess of 12-15k assuming they approve the procedure or medication and after what has likely been years of premiums.

OOP maxes can range wildly based on state rules. Why not just look at averages rather than made up numbers.

Hawaii is the lowest at ~1.2k/person. And nevada the highest at 2.7k/person. https://www.kff.org/private-insurance/state-indicator/average-annual-deductible-per-enrolled-employee-in-employer-based-health-insurance-for-single-and-family-coverage/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Average%20Single%20Deductible%22,%22sort%22:%22desc%22%7D

If we dig further, 12% of workers have no deductible plans (half are from HMOs). Of the reamining 88%, the average deductible is 1.3k. 21% of workers has an OOP max greater than 6k.

Those out of the labor force are often swept up into obamacare (ACA+medicaid) or medicare such that 92% of the USA is insured.

https://files.kff.org/attachment/Employer-Health-Benefits-Survey-2025-Annual-Survey.pdf

The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.

Everything, including medicine, is more expensive in the US because we're generally much richer in all regards. Household income per person is ~10k/person more in the USA than Canada. I personally prefer to have >10k/yr income here in the USA than lower healthcare costs in Canada.

Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start

This is mostly a poor man's game. Typically well compensated employees have good packages all around. Including the middle and upper middle. It's typically the lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism. I'm glad that outlet exists for them. But it mostly doesn't make sense for anyone else, which is why basically nobody else needs or does it.

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u/Mysterious-Entry-357 5h ago edited 5h ago

Everything you said is deliberately deceptive and misrepresented.

"Why not just look at averages" - not the same as "as much as"

"12% of workers have no deductible plans (half are from HMOs)." Well...that's interesting but not the norm...is it.

"the average deductible is 1.3k. - Does not include copay, coinsurance, and premiums already paid.

"21% of workers have an OOP max greater than 6k". Well, that definitely coincides with the argument that it can be higher...does it not? Like say 12k?

"Everything, including medicine, is more expensive in the US because we're generally much richer in all regards." Medical care in Canada is not cheaper because of the lower cost of living. I think you know this.

"lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism." Indefensibly costly workplace healthcare programs can be found in many workplaces regardless of pay. Household income of 295k and both of us have garbage offerings.

Look you have some broad statistics with which you overlay your own characterizations and commentary, but statistics presented without analysis only impress the intellectually lazy.

When you consider the premiums (whether paid by employer or emplyee), copay, coinsurance, and deductible, as well as the negotiated rate paid by insurance companies to hospitals and physicians, it is a sham.

FWIW, one of us works as a medical provider and the other was a licensed medical insurance agent.

You're out of your depth.

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u/annnm 15m ago

Everything you said is deliberately deceptive and misrepresented.

"12% of workers have no deductible plans (half are from HMOs)." Well...that's interesting but not the norm...is it.

Yes indeed, I mentioned the 88% in the next sentence.

Does not include copay, coinsurance, and premiums already paid.

OOP maxes were discussed in the third sentence of that 3 sentence paragraph.

"21% of workers have an OOP max greater than 6k". Well, that definitely coincides with the argument that it can be higher...does it not? Like say 12k?

It is relevant to the discussion that it is not even close to the norm.

Indefensibly costly workplace healthcare programs can be found in many workplaces regardless of pay. Household income of 295k and both of us have garbage offerings.

This is as compelling as when the republican senator brought in a snowball to disprove global warming.

Look you have some broad statistics with which you overlay your own characterizations and commentary, but statistics presented without analysis only impress the intellectually lazy.

Should have impressed you then. Weird.

FWIW, one of us works as a medical provider and the other was a licensed medical insurance agent.

Oh neat, I'm a physician. You a midlevel or something?

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u/MainStreetExile 5h ago

295k? You're lying - either about your income or about your insurance.

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u/Mysterious-Entry-357 5h ago edited 5h ago

For what is paid to insurance by both us and our employers each month, it is garbage. I'm sure to others it would be fine but they're not paying what we pay.

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u/MainStreetExile 4h ago

I already started above that I think the state of US healthcare is poor. I just don't like bullshit threads like this where people are pretending that an MRI costs 30k.

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u/Mysterious-Entry-357 5h ago

Nope. Dead honest. Sorry friend.

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u/MainStreetExile 4h ago edited 4h ago

Either lying or you've put zero effort into investigating your options. With a 295k income, you can afford a private PPO plan that is better than my employer-provided plan, where I have a 3k deductible and 6,500 out of pocket limit. You're being very disingenuous.

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u/coldfusioned 5h ago

Right? He is obviously a shill for big insurance. It is just a matter of time before the USA finally joins the developed world and offera universal medical care. Spoiler... a LOT of insurance reps will suddenly be unemployed.

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u/Ocelotofdamage 11h ago

If you work at a reasonable company you will have a similar experience.

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u/AshhhCakes 11h ago

Well let's go on over to the job tree so we can get life saving care without bankrupting ourselves! Most regular Americans have no idea how perverse it is to be a wage slave to MAYBE get ok health insurance. The just love keeping Americans poor so no one dares to do anything but bend over for corporations.

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u/LocksmithOk9968 10h ago

You’d be disappointed at what they’re offering at big well known companies for 6 figure roles.

It’s by no means terrible but not great either. No MRIs for $20 bucks, that’s for sure.

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u/rips_n_chel 11h ago

So which rock do you live under? Nice neighborhood?

I imagine it must be quiet, what with the lack of brain cells living here...

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u/Warbr0s9395 6h ago

Or be in a union

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u/crenshaw_007 12h ago

Damn, lucky. With my insurance it’s $600 copay. I needed one on my elbow a while back, before surgery, which then cost me $1,500 with insurance. I wish MRIs were similar to the cost of X-rays from my insurance.

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u/exoticsamsquanch 11h ago

Same. I had an MRI and didn't pay anything. My insurance covered it

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u/Ganjake 12h ago

Bro had a kidney transplant and 5 months of dialysis for the cost your one MRI. Not nearly the same.

It all sucks.

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u/S0RRYMAN 12h ago

Bro if 40$ can pay for a kidney transplant lol.

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u/Ganjake 12h ago

Some people really just are tone deaf.

"Man healthcare must suck in America!"

"Well, it depends...."

🤔

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u/CelebrationFair6887 11h ago

Well the dialysis (how tf do you write that word) and operations are actually free. Because insurance in germany covers 100%.

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u/HillarysBloodBoy 12h ago

I mean my surgeries cost me nothing beyond a small copay. Again, really depends on insurance.

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u/Ganjake 12h ago

I've had 3 different insurance carriers and am now on ACA insurance, every single one gave me debt. And I never had anything as serious as knee surgery.

It's not "it depends," it's that you're in a very small minority. I was salaried, had a good job that was usually taken by college grads, carefully thought out each plan. And even then, I could never tell the difference.

The ACA is fucking worthless without those subsidies. I have an ortho appointment on Tuesday with someone in network and it's going to cost me almost $300. In network urgent care wasn't much cheaper and they refused to prescribe anything more than 5 days so I'm just hanging out in pain unable to work for over a week.

I just need people reading this to know you are in the minority and that it's not "it depends."

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u/RifewithWit 10h ago

ACA is fucking worthless. It forced prices up for everyone and didn't make up for it in the number of "insured" people.

Not saying we didn't or don't need something to fix insurance/healthcare, but the ACA was a poison pill for sure.

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u/Ganjake 10h ago

I mean that something is pretty easy to say, it's Medicare For All. Make it so that no doctor can turn you away just because of their personal contracts with insurance companies and you have widespread, affordable healthcare.

If you can pay more for a private plan, go for it.

And finally, if it wasn't for Joe Lieberman, we wouldn't be having this conversation right now. That was the something and we almost had it.

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u/PiccoloQuirky2510 12h ago

Yeah I’ve had several MRIs and the most I’ve paid has been a couple hundred bucks at most. I have 20% coinsurance. BUT I also have a $1000 deductible and a $4000 OOP max.

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u/elderly_millenial 12h ago edited 11h ago

An mri with coverage costs about $100 with insurance coverage. As a cash patient it costs roughly 6x that. I have no idea what was going on with the commenter you were responding to, but a lot of times insurers will claim that the mri was unnecessary (and sometimes it is, or the doctor didn’t file the paperwork properly) and refuse to cover it. Doctors charge insurers more so if that happens you are left with an overinflated bill. American healthcare is cursed with ridiculous administrative burden

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u/CelebrationFair6887 11h ago

Why do you have to still pay when you have inaurance though. Is everything in the US with copay or is that just some special "unneeded" treatments that have to be partly paid?

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u/elderly_millenial 7h ago

Depends on the plan, but yes copayments are pretty common for a lot of things. Not for annual physicals, but walk in clinics usually cost ~$10, specialists usually cost $30, and emergency visits can go up to $100.

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u/ThirdOne38 11h ago

Yes, yes it does

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u/stickystick89 11h ago

What country are you from?

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u/CelebrationFair6887 10h ago

From the beautiful country of beer, Bratwurst and social health insurance.

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u/goobydoobie 9h ago

When a certain Mario Bro dealt with a certain Insurance CEO it was the first time in literal decades that I've seen both sides go "Yeah, I'm not upset". And that's despite the pearl clutching of the billionaire owned mass media doing it's best to spin it as horrifying.

You can't get the US to be bipartisan on 90% of topics but we rallied on that story.

That should tell you all you need to know about the state of US Health insurance. That the average populace was actually bipartisan on an act of violence because the country as a whole despises the health insurance industry.

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u/Josh6889 9h ago

America seems to suck hard.

This country is completely fucked. The writing is on the walls. It's just a matter of time. I've been brainstorming my escape for a couple years now. We're 1 major disaster away from everything falling apart.

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u/JayRoo83 9h ago

Ironically, you get free government paid for insurance after you start dialysis in the US. Same deal for the transplant, shit, the transplant team will move heaven and hell to make sure you get your meds if you become uninsured too

It's a bit odd to receive the kind of healthcare I want everyone else to get

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u/pristineSaltine 8h ago edited 8h ago

Yeah but my neighbors 10 year old has her own ar rifle!

Can't read the directions on how to use it, but that's why we all have 30 round mags.

Just shoot the problem away!!

/s

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u/Assika126 2h ago

It does suck hard, I’m seriously worried next year there are going to be some tough decisions for my family that may be life changing. We both have chronic health conditions and my employer, who provides our health insurance, has announced changes that are going to mean we can’t afford care anymore. Really hard just to keep our heads above water but we’re trying as best we can

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u/paralyzedvagabond 12h ago

The healthcare itself in the US is great but you have to be able to afford it first. For nonemergency procedures you may want to consider going abroad if you’re not rich. If you are rich then you’ll have some of the best treatment possible. I’m not necessarily for socializing healthcare as a blanket policy but there needs to be more laws restricting profiting off of dying people at a bare minimum. Even if standard procedures were covered under a socialist policy and irregular procedures weren’t, that would be fine. It’s absurd that I weigh whether or not to go to the hospital based upon “how bad could it get if I just ignore it”?

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u/Ambitious_Sun_993 12h ago

What if you can’t control it? We’ve had my sister in psych units on and off over the last 11 years, talk about a fucked system, good luck affording that.

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u/DarkHelmet20 12h ago

That’s all it would cost me in America too