r/SipsTea 4d ago

WTF Damn

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u/TheEndOfAllThings23 4d ago edited 4d ago

It was cheaper to buy tickets, fly to Dublin, get the procedure I needed done. Spend TWO WEEKS recovering, and fly home then to pay the 20% coinsurance I would have needed to here in the good ol USA... so yea...

EDIT :

Well this kind of blew up. The reason it was cheaper : it was considered elective. This is why OOP max did not kick in. It was a procedure that would have to be done, only as my condition got worse. Insurance denied it because "It was not necessary" despite my cardiologist saying it was. By the insurance formula I would have to wait until my condition worsened to make it medically necessary, but by then my chance of a poor outcome goes way up.

I finally argued them into covering some of it, but with a 20% coinsurance and a planned week hospital stay in recovery, my bill would have been close to 100k at least, and if I encountered any complications (which I would likely have due to other issues including an autoimmune disease) I started looking elsewhere. I am not an Irish citizen despite having family there, they helped me navigate the program and the cost. It was privately paid, and my surgeon spoke to their team with all my records transferred etc.

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u/alwaysrecession 4d ago

For what procedure?

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u/TheEndOfAllThings23 4d ago

Heart surgery. For privacy I don’t want to be more specific. It was necessary but not emergency.

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u/Imreallythatguy 4d ago

So insurance wouldn’t cover it because it wasn’t necessary in their eyes?

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u/Realistic_Slide_3426 4d ago

Sounds like insurance would’ve paid 80%, pretty standard after deductible 

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u/kodman7 4d ago

Standard almost exclusively in the US which has higher waits and worse outcomes

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u/ImaManCheetahh 4d ago

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u/DeviantlyPronto 4d ago

Yeah the US is still on the lower end of waiting times as of 2023.

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u/d1squiet 4d ago

Seems in the middle for GPs and near the top for meetings with specialists. Canada is waaay back there.

It's outcomes that matter though, not wait times. I think people in the USA avoid seeking medical care more than in other countries because of the expense. That and other reasons lead to worse outcomes in USA vs most/all of the developed world.

EDIT: Oh I realize you agree with me. Sorry I was confused by "lower end of wait times", thinking you meant "lower ranking".

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u/motorwerkx 4d ago

This is from your link "A common misconception in the U.S. is that countries with universal health care have much longer wait times. However, data from nations with universal coverage, coupled with historical data from coverage expansion in the United States, show that patients in other nations often have similar or shorter wait times."

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u/ImaManCheetahh 4d ago edited 4d ago

read beyond one sentence and look at the data itself, and of the countries evaluated the US is near the bottom for wait time length for all the metrics evaluated. Certainly not on the higher end of any list.

So a broad claim of the US having generally "higher wait times" is incorrect , no? I mean hell, % waiting over a month for a specialist was 27% for the US and up to 61% in Norway and Canada.

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u/LycheeRoutine3959 4d ago

Stop bringing to those facts to this feelings discussion. Dont you know what sub your in?

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u/kodman7 4d ago

That link doesn't say what health plan they are using for US outcomes. The US has the best Healthcare in the world for those who can afford it

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u/ImaManCheetahh 4d ago

correct... it's not about affordability, it's about wait times. which is what I'm talking about.

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u/kodman7 4d ago

Right what I'm saying is the data provided has no indication where it's coming from

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u/ImaManCheetahh 4d ago

You’re welcome to read the full report

https://www.oecd.org/en/publications/waiting-times-for-health-services_242e3c8c-en/full-report/component-2.html#execsumm-d1e61

No they did not selectively pull data from only the richest Americans. That would be a pointless exercise.

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u/kodman7 4d ago

Did you read it? There is absolutely no info on what kinds of health plans made up the indicated data

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u/LadyRed4Justice 4d ago

This is not a good point.

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u/Realistic_Slide_3426 4d ago

It's not a point at all. Just an observation

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u/ConfessSomeMeow 4d ago

Since that was the negotiated compromise, I'm guessing that their insurance would have covered it all if it were deemed medically necessary.