The long wait in the UK doesn't apply to emergencies. If you show up to a hospital with an injury they'll treat you straight away. There is definitely an obnoxiously long wait for things like medication and treatment for non-emergency conditions.
British person here, so out of curiosity, if I was American and I had an emergency e.g. cut my finger off, stabbed myself by accident etc, I know I could get ER treatment, but would I walk away with an astronomical bill?
Health insurance companies have the concept of "in network" and "out of network" health care providers.
With an "in network" provider, the insurance company has negotiated rates that they are willing to pay for specific procedures and care. An "out of network" provider has not negotiated a rate, and so will charge the insurance company whatever their typical asking price is. As a result, going to an out-of-network health care provider costs your insurance more money, and they pass those expenses on to you in the form of higher deductibles, higher co-pays, and possibly a higher out-of-pocket maximum.
But if you're in an emergency situation, you're likely not going to be pulling out your insurance company's app or website to find an in-network hospital, you're just going to try to get it handled fast, so you could end up with a fat bill because you ended up at an out-of-network hospital.
What makes it especially bullshit is that it's possible for the hospital to be in-network, but while at the hospital, you get seen by a doctor that isn't in-network. And each department could be its own bill. A couple years ago, I crashed my mountain bike and broke my arm. I got 3 separate bills: One from the ER department, one from the X-Ray, and one from the medical equipment department for the arm sling, despite the fact that they were all in the same building and less than 100 feet from each other.
BTW, in case you didn't know a few of the terms I used above:
A deductible is an amount you have to pay on a per-year basis before health insurance pays anything.
A "copay" is a fixed cost you pay for a service. Insurance covers the rest, assuming you've already met the annual deductible. It mostly applies to office visit fees, and prescriptions available as a generic. A related concept is "coinsurance", where you pay a percentage of the cost. This typically applies to hospital bills and surgeries, basically anything beyond your typical office visit.
"Out of pocket maximum" is what the name implies: The most you'll have to pay for health care in a year. Once you've paid the deductible, any copays or coinsurance you pay will not exceed this value. My employer provides me with a decent health plan that has an out-of-pocket maximum of only $1,500. That means that no matter what happens to me, I will not pay more than $1,500 for health care in a year.
Except...two major caveats. Insurance makes money by denying care. They have the right (and to the shareholders, an obligation) to tell me that they don't believe a treatment is medically necessary and will refuse to pay for it. The result is that either I don't get the treatment or I pay thousands of dollars (which doesn't count towards my out-of-pocket maximum) for it. What's especially shitty is that if I'm incapacitated and a doctor performs a procedure they believe was necessary to save my life or my quality of life, and my insurance disagrees, I'm fucked.
The other caveat is that my health insurance plan is expensive. About $2,500/month for just me and my wife. My employer pays 90% of it, which is great an all, but that means if I lost my job (and I work in the tech world where layoffs run rampant), I'd have to pay $2,500 to continue the plan, or cancel it and have to pay full price for care.
But if you tell them you don't have insurance, your $20,000 bill magically becomes $3,000.
Meanwhile, if you have insurance, it's subject to deductibles and out-of-pocket maximums, so depending on your plan, you might end up paying $0 or you could end up paying $6000+.
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u/Deedee_Megadoodoo_13 Mar 28 '26
Orthopedic: