Quote:
Originally Posted by New Era
Here's the thing about this anecdotal evidence. Both are likely accurate based on the situation of the individuals in question.
One individual lives in the 3rd largest metropolitan area in the nation, and is fairly affluent, based on their commentary. It is very likely they have a really good job, get paid a lot, and have a benefits package that most would consider gold plated or Rolls Royce. So they have an advantage of having low deductibles and excellent access. Being in the 3rd largest metro area has its advantages as well. Chicago has 91 hospitals in a 20 mile radius of the center of the city. Illinois is also a very liberal state where there are a huge number of insurance programs available. There is a high density of good service providers and specialists. You have a high degree of choice and your plan likely allows a high degree of choice between service providers, including specialists.
The other individual lives in the 47th largest metropolitan area in the country. Population density is a fraction and access to providers is obviously going to be restricted. Tulsa has access to 29 hospitals within a 50 mile radius of city center. This individual is not affluent and more of a member of that shrinking middle class. It is likely the individual does not have a high paying job, is limited on benefits, and has to make due with those benefits provided by employer. Oklahoma is a state which fought the idea of health exchanges and has very limited choice in the system for those who have to buy from that marketplace. The majority of these programs have high deductibles to keep insurance costs down and pass a lot of the costs off to the insured. Depending on where the individual lives in Tulsa, they could be subject to "rural medicine" classification, making access to services extremely difficult.
Context of this issue is important. Listening to someone who has fantastic insurance and lives in the middle of a large urban area can give the impression of everything being rainbows and unicorns. Listening to someone who lives in a smaller population center and lives paycheck to paycheck, the picture is very different. Both can be right, but it is the contrast that shows you everything that is wrong with the system itself.
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Did you just call me poor?!?!?!!??!
I do agree both can be accurate. Something I meant to articulate in response to Eldrick was that my situation with copays is similar to his. They are usually pretty reasonable. I can actually go to an urgent care near me for run of the mill stuff and get charged a normal visit copay. So that is nice if the kids pop up sick and we can't get in to the pediatrician as quick.
Also, for someone that asked me about my deductible/plan, we have a traditional PPO plan as opposed to the newer high deductible plans that include the HSA money. I looked at the billing summary and we actually maxed out our yearly out of pocket maximum for our son, so I'm not sure why the bill was that high. Both our kids had tubes when younger and I think at the time were on my insurance and the amount was still similar.