I want to contrast the current top rec'd diary to the very awesomeness of the system we currently have in the U.S.
I am the insurance success story in the United States. I have an employer who foots a good amount of my health care costs. I am a relatively young professional, who has been with the same company about 8 years. I have seen my portion of the premium per paycheck double from about 45 dollars to 93 dollars per month. My employers portion has gone from about 4 times that to 4.5 times that. For this dollar amount, I went from a no deductible plan with a 20 dollar copay to a 3K deductible plan. My only covered portion is one annual visit. I'm fortunately relatively healthy now.
Back when I had the good plan with only a co pay for most items, as long as they were in network, which was 4 years go, I cracked my ankle playing basketball. I actually rested on it for a few hours, just in case, but since it was entirely black from midfoot to about 3 inches above the ankle ball (real medical expert here), and I was unable to put any pressure on it and decided after much prodding from a couple friends who looked at it to go to the ER. After spending 6 hours at the ER at midnight, and 2 sets of XRays at one of the top 10 hospitals ranking wise in the country (since the first doctor messed up reading it and thought it was just sprained until the soft cast he tried to put on had me in tears instantaneously). They hadn't Xray'd the part of the ankle that had actually fractured. So they suggest a specialist for me to see the next day to fully diagnose it. Unfortunately, as I found out later, my insurer didn't think this was an emergency. So I got a bill for 150 dollars. So I went to the specialist, and he had trouble seeing the fracture at first as well. His office also could not find my insurance information (unlike the hospital the night before, which found it right off the bat). So I got billed for the entire amount, even after sending this multiple times in the past 3 years (let's say it's still in collections in full, since the insurance and the doctor never got together and now my employer doesn't offer this plan since they were priced out, so the insurer has no vested interest in helping me out.). Obviously I'm still not paying it as I spent (between my employer and I) $4900 on insurance that year for one issue.
After this debacle, I have been reluctant to see doctors, as these problems and the adverse affect on everything from finding an apartment once this goes on the report (yes, I could pay it but F that, it was covered so why should I pay 500 dollars extra). Well this year, I started getting really dehydrated in February. I've had the same primary care for 14 years and I had one visit covered by my now high deductible plan. So i called up to make a non urgent appointment. He has an N.P. who offered to see me a week later. So I went into the office, and he saw me for exactly 4 minutes for a basic once over (45 minutes after my appointment) and figured out nothing. So he ordered blood tests in the same office, which standard to every physical I have before, I took. He called back and asked if anything was still bothering me, which the dehydration was, so he set up an appointment with my doctor to review. So my doctor saw me for 7 minutes a couple weeks later. He suggested I go see a specialist, but knowing my situation, I said I could live with it, as the cost of his visit was enough to deter me (knowing the second visit would not be part of my annual visit/physical coverage). He says alright and confirms this was part of a physical by stating specifically to make sure I come in for my annual visit next year and not be such a stranger (unless it got unbearable). So I get a bill for 400 dollars for the bloodwork (because the lab in my doctors office somehow lost my insurance info at first). Then I get a 75 dollar bill for the first visit (which when I called my insurer, and then emailed a supervisor, I was told it was because in the course of the physical, a medical diagnosis was made). then I get a second office visit bill for 75 dollars as well.
Of course, I sent the bloodwork bill back with the insurance info they already had, and they realized that since they had a deal with my insurer, they would only charge 129 dollars. So for 11 minutes of visits, in which nothing was resolved, no issue was solved, and no real concrete information was provided, I had racked up 279 dollars in bills. So now of course, there is no way I am seeing a specialist, since it will be another few hundred in a bad economy at the best case scenario, with no real hope this would be the end. So basically I threw out 300 dollars, at least 200 would have been covered had my doctor not known something was wrong (no change in procedure, mind you).
So to summarize, not including the prior years I don't remember, in the past 5 years, I have had 2 issues with 4 office visits, spent about $5,200 personally with my company spending another $20,000 dollars for health insurance. What I have gotten for said coverage is a small collections claim for 500 dollars, for a doctor who did nothing, for an injury that I had to let heal on its own in an ace bandage (as they thought a hard cast wasn't worth it) and crutches, on something that per my plan was definitively covered, and 300 dollars in bills for about 20 minutes total in treatment (between lab and 2 doctors visits) that cured nothing and made me scared what would happen to me financially had they found something while risking another few hundred in the best case scenario, for a physical that should have been covered in the first place and a second visit that would have been 75 dollars. Not to mention the fact that my insurance gets charged 4 times less than they would have charged me to begin with, which is disgusting. And in this system, I'm one of the "lucky ones". And the key is, not one thing was covered and it's mandatory in my state of MA for me to continue to pay for this or I get a tax penalty...Yeah, no changes needed here.