人們是否夸大了美國醫(yī)療系統的問題，還是說如果你沒有保險，情況真的那么糟糕？

Gerald Hawkins
My son was attacked and murdered at his college. When he was rushed to the emergency room before being pronounced dead, they processed him in as uninsured. Three days after his death we received two things from the hospital. The first was a bill for $38,000. He was there 7 minutes before being pronounced dead. The second item was a letter informing him (the deceased) that he was no longer welcome at that hospital as an “indigent person.” That is the way a crime victim is viewed in the American health care bureaucracy.

我的兒子在大學里遭到襲擊并被謀殺。在被宣布死亡之前，他被緊急送往急診室，醫(yī)院將他作為無保險人員處理。在他去世三天后，我們收到了醫(yī)院的兩樣東西。第一樣是一張38,000美元的賬單。他在那里待了7分鐘就被宣布死亡。第二樣是一封信，通知他（死者）他不再被歡迎作為“貧困人員”在那家醫(yī)院就診。這就是美國醫(yī)療官僚機構看待犯罪受害者的方式。

My son had to have insurance to get into college and be a student there. They knew he had insurance. They simply found it easier to ignore the insurance and degrade him as “indigent.” We had to go through the difficulty of connecting his insurance to the medical center’s billing department even while dealing with our grief and loss.

我兒子必須要有保險才能進入大學并成為那里的學生。他們知道他是有保險的。他們只是覺得忽略保險并將他貶低為‘貧困’更容易。我們不得不在處理悲痛和失落的同時，艱難地將他的保險與醫(yī)療中心的計費部門連接起來。

Later a bill arrived for $2,000 in ambulance services, billed separately, of course. Insurance eventually paid all but $100, but only after (again) I had to get his insurance connected to the ambulance company’s billing.

后來，我收到了一張2000美元的救護車服務賬單，當然是單獨計費的。保險公司最終支付了除100美元之外的所有費用，但前提是我必須再次將他的保險與救護車公司的賬單系統連接起來。

Yes, the American health care “system” is absolutely as bad as can be.

是的，美國的醫(yī)療“系統”確實糟糕透頂。

Cris Larson
My husband had hit a deer and part of his truck bumper was torn; one day I was rushing past it and tore a hole open on my thigh. It wasn’t a big hole - maybe an inch long, but it had some weird fatty tissue hanging out. Weird. I didn’t think it was so bad - but we tried to close it up with band-aids and such, but the tissue kept popping out.

我丈夫撞到了一只鹿，他的卡車保險杠部分被撕裂了；有一天我匆忙經過時，大腿上被劃開了一個洞。洞不大——大概一英寸長，但有一些奇怪的脂肪組織露出來。很奇怪。我當時覺得并不嚴重——我們試著用創(chuàng)可貼之類的東西把它合上，但組織總是彈出來。

A few months earlier, I had had to discontinue our insurance because the premium had become higher than my take-home pay.

幾個月前，我不得不停止我們的保險，因為保費已經超過了我的實得工資。

The next day was Saturday, and I still couldn’t get the wound to close up. So we went to the nearby emergency room - this was before urgent care centers opened up. I kept telling the nurses it wasn’t bad but that I might need a stitch or two, and we wondered how much it would cost to have the doctor just look at it. We kept asking and asking about the cost, but nobody would give us a straight answer, or any answer at all, for that matter. We said we really wondered if it would be worth seeing someone for something relatively minor - the folks there convinced us to stay to be looked at.

第二天是星期六，我的傷口仍然無法愈合。于是我們去了附近的急診室——這是在緊急護理中心開業(yè)之前。我一直告訴護士情況并不嚴重，但可能需要縫一兩針，我們想知道讓醫(yī)生看一下要花多少錢。我們一再詢問費用，但沒有人給我們一個明確的答案，甚至沒有任何回答。我們表示，我們真的想知道為了相對較小的問題去看醫(yī)生是否值得——那里的人說服我們留下來接受檢查。

We waited around two hours. The doctor came in, and said she couldn’t stitch it because we’d waited too long, but that she could give me a tetanus shot and a bandage. So I got a tetanus shot and a bandage. All done in about five minutes.

我們等了大約兩個小時。醫(yī)生進來后說，因為我們等得太久了，她不能縫合傷口，但她可以給我打一針破傷風疫苗并包扎一下。于是我打了破傷風疫苗并包扎了傷口。整個過程大約五分鐘就完成了。

The cost? $11,000. That’s not a typo. Eleven. Thousand. Dollars.

價格？11,000美元。這不是打字錯誤。十一。千。美元。

Once I had recovered from the shock, I went back to the hospital to talk about payment. I told the man I couldn’t really afford it - and he chuckled and said that I should apply for charity care. I think I eventually ended up paying a couple thousand dollars for the doctor, ER, and medication cost.

當我從震驚中恢復過來后，我回到醫(yī)院討論付款事宜。我告訴那個人我確實負擔不起——他笑了笑，說我應該申請慈善醫(yī)療。我想我最終為醫(yī)生、急診室和藥物費用支付了幾千美元。

The most telling thing about the whole experience was the cynical, wry chuckle from the payment administrator at my disbelief. It certainly sealed my belief that the entire American health “system” is a joke - a deadly serious nasty joke.

整個經歷中最能說明問題的是，支付管理員對我難以置信的反應發(fā)出了憤世嫉俗、諷刺的輕笑。這無疑堅定了我的信念，即整個美國的醫(yī)療“系統”就是個笑話——一個極其嚴肅且令人不快的笑話。

Howard Forder
It is that bad if you don’t have insurance. As a Canadian visiting Florida, my wife had a dangerously high fever and was slurring her words and couldn’t get out of bed. I reluctantly called an ambulance. (not because I didn’t want her to receive medical help, but because we would have to take out a loan to pay for it). My wife is fine now, but listen to this:

如果沒有保險，情況會很糟糕。作為一名訪問佛羅里達的加拿大人，我的妻子發(fā)高燒，情況危險，說話含糊不清，無法起床。我勉強叫了救護車。（不是因為我希望她不接受醫(yī)療幫助，而是因為我們將不得不貸款來支付費用）。我的妻子現在沒事了，但請聽這個：

To make a long story short, she was in Emergency for 4 hours before they released her, fever down and ok to go home. Total hospital bill: $17,000 USD ($24,000 CAD). Surprise Doctors bill 45 days later $2000. Ambulance bill $1000 and a later bill from “TeamHealth” for two ghost doctor visits for $1800. She had a catscan which I would presume is the big expense, a saline drip, antibiotics and sent home. Only the wealthy can throw that kind of money around. The rest of us need a loan or mortgage our home.

長話短說，她在急診室待了4個小時后才被允許出院，當時燒已經退了，可以回家了?？傖t(yī)院賬單：17,000美元（24,000加元）。45天后收到了一份2,000美元的醫(yī)生賬單。救護車賬單1,000美元，后來還收到了“TeamHealth”寄來的1,800美元賬單，聲稱有兩次“幽靈醫(yī)生”的訪問。她做了CT掃描，我猜這是最大的開銷，還有生理鹽水點滴、抗生素，然后就被送回家了。只有富人才能隨意揮霍這么多錢，我們其他人需要貸款或抵押房子。

Our neighbor in Florida was in the hospital for 3 days and had a bill for $30,000. She had to sell her house and move in with her daughter. She won’t go back into the hospital as she can’t afford it.

我們在佛羅里達的鄰居在醫(yī)院住了3天，賬單高達3萬美元。她不得不賣掉房子，搬去和女兒同住。她不會再回醫(yī)院，因為她負擔不起。

Michael Mock
Oh, it’s that bad even if you DO have insurance, too.

哦，即使你有保險，情況也那么糟糕。

My appendix burst. I have “good” insurance (PPO Gold). For this, they billed me somewhere north of $18,000, despite my having a “$4000 maximum yearly out-of-pocket” clause on my insurance.

我的闌尾破裂了。我有“很好”的保險（PPO Gold）。盡管如此，他們還是向我收取了超過18,000美元的費用，盡管我的保險中有“每年最高自付額4,000美元”的條款。

I fought with the insurance company. They insisted I pay the full amount, because I went to the emergency room. I asked them to please list for me all the non-emergency ways your appendix can burst, and pointed out that if I’d gone in before it was a problem to have my appendix removed, that wouldn’t have been covered because it would have been “elective” surgery.

我與保險公司發(fā)生了爭執(zhí)。他們堅持要我支付全額費用，因為我去了急診室。我請他們列出所有非緊急情況下闌尾可能破裂的方式，并指出如果我在問題出現之前就去切除闌尾，那將不會被覆蓋，因為這將被視為“選擇性”手術。

They still insisted I pay the full amount. To date I’ve paid $0 of that amount. Now they want to settle, if I’ll pay $2000. I asked why they wouldn’t just take $4000 from the start, and they said I had to pay the full amount.

他們仍然堅持要我支付全額。到目前為止，我支付了0美元?，F在他們想要和解，如果我支付2000美元。我問他們?yōu)槭裁匆婚_始不直接收取4000美元，他們說必須支付全額。

No matter the question, the answer seems to stay the same, and my response has remained consistent as well. I’ve cratered my credit rating on principle, and I don’t care.

無論問題如何，答案似乎始終如一，我的回應也保持一致。我基于原則毀掉了我的信用評級，但我并不在乎。

Kathy Hakeem
I'm 72 years old. I can't afford my meds. The copay is over $200 per month. I worked my whole life since age 16. My Social Security so low that I don't have a spare $200 each month. Therefore I take half the meds per day that I am supposed to and chose which ones I can afford to get each month. I work most days but don't make enough to afford most anything. However I make $3 per month too much get any government help. I've already accepted that should I get sick,dieing is my only option. Health care in the US sucks unless you are rich.

我今年72歲。我負擔不起我的藥物費用。每月的自付額超過200美元。我從16歲起就一直工作。我的社會保障金很低，每個月沒有多余的200美元。因此，我每天只服用應該服用的一半藥物，并選擇每個月能負擔得起的藥物。我大部分時間都在工作，但賺的錢不夠支付大部分開銷。然而，我每個月多賺了3美元，因此無法獲得任何政府幫助。我已經接受了，如果我生病了，死亡是我唯一的選擇。在美國，除非你富有，否則醫(yī)療保健很糟糕。

Something I clicked on made comments impossible but I can't figure out how to undo that. Sorry.

我點擊了某個東西導致無法評論，但我不知道如何撤銷這個操作。抱歉。

I had my appendix burst in August 2020, and I wrote about it here in Quora. My hubby transported me to Jorvi hospital, which is the central hospital of my hometown (Espoo, Finland). It also is a university hospital, which means the medicine students are instructed there, and new forms of treatment are beta tested there. I was operated the next morning.

我在2020年8月經歷了闌尾破裂，并在Quora上寫了關于此事的文章。我丈夫將我送到了我家鄉(xiāng)（芬蘭埃斯波）的中心醫(yī)院Jorvi醫(yī)院。這也是一所大學醫(yī)院，意味著那里有醫(yī)學生接受指導，并且新的治療方法在那里進行測試。我在第二天早上接受了手術。

The good old Jussi Q. Veronmaksaja, the Finnish cousin of John Q . Taxpayer, paid the operation which saved my life. Its price to the Espoo taxpayers (in Finland, the health care is funded by the communal tax) was 3,000 euros.

善良的老Jussi Q. Veronmaksaja，芬蘭版的John Q. Taxpayer，支付了拯救我生命的手術費用。對于埃斯波（芬蘭）的納稅人來說，這項費用（在芬蘭，醫(yī)療保健由社區(qū)稅資助）是3000歐元。

Since there are some 300,000 inhabitants in Espoo, my life was saved by 3000/300,000 = 1 cents per every Espoo inhabitants. If half of us are net taxpayers, it is 2 cents per taxpayer.

由于埃斯波有大約30萬居民，我的生命被拯救的成本是3000/300000 = 每個埃斯波居民1分錢。如果我們中有一半是凈納稅人，那么每個納稅人的成本就是2分錢。

If I had had more time to act (rather than be curled up like a shrimp and agonied in pain), I could have opted a private hospital in Helsinki. The price would have been 3,500 euros. Since because of my stupid hobbies, which bear an elevated risk of injury and death, I am compelled to take a private health insurance, it would have covered 90% of the costs, making the price 350 euros for me - a lot but manageable. My private health insurance costs me 150 euros per year. Pricey, but manageable.

如果我有更多的時間行動（而不是像蝦一樣蜷縮著痛苦地呻吟），我本可以選擇赫爾辛基的一家私立醫(yī)院。價格將是3500歐元。由于我那些愚蠢的愛好，它們帶來了較高的受傷和死亡風險，我不得不購買私人健康保險，這將覆蓋90%的費用，對我來說價格將是350歐元——雖然不少，但可以承受。我的私人健康保險每年花費我150歐元。雖然昂貴，但可以承受。

I did a short inquiry about the prices of appendectomy in the USA, and the prices are between 30,000 to 70,000 USD. My jaw dropped. Do they make the instruments from platinum in the USA, or is this a particularly audacious case of arbitrage?, I pondered. In the USA, had I not had an insurance, it would have cost me literally an arm and a leg - and the worst case scenario would have been personal bankruptcy and becoming homeless.

我做了一個關于美國闌尾切除術價格的簡短調查，價格在3萬到7萬美元之間。我驚呆了。我在想，難道他們的手術器械是用鉑金做的嗎，還是這是一個特別大膽的套利案例？在美國，如果我沒有保險，這將花費我一條胳膊和一條腿——最壞的情況將是個人破產和無家可歸。

The cheapest private health insurances in the USA begin from 1200 USD per year - and they do have a cost ceiling and do not cover pre-existing conditions. In the USA, I would pay tenfold the amount of the private health insurance as I do in Finland - and having it to cover the costs is crapshoot.

美國最便宜的私人健康保險每年從1200美元起——它們確實有費用上限，并且不涵蓋已有疾病。在美國，我將支付芬蘭私人健康保險金額的十倍——而能否覆蓋費用則是一場賭博。

Appendectomy is pretty much a basic surgery, it is approximately the same procedure all around the world, and the medicines and instruments used on it are approximately the same everywhere. I haven’t seen the American hospitals being five star hotels with hospital equipment either.

闌尾切除術基本上是一項基礎手術，在世界各地的手術程序大致相同，使用的藥物和器械也大致相同。我也沒有見過美國的醫(yī)院像五星級酒店一樣配備醫(yī)院設備。

Yes, the American health care system is indeed that bad. I call it rent-seeking.

是的，美國的醫(yī)療體系確實很糟糕。我稱之為尋租。

LivinItUpandLivinItOutSitBackRelaxandLove

盡情享受，盡情生活，坐下來放松，去愛

Hi, my husband didn’t have health insurance when he was 24 he had a seizure and went in an ambulance to the ER. He was there maybe three hours and sent home.

你好，我丈夫24歲時沒有健康保險，他有一次癲癇發(fā)作，被救護車送到了急診室。他在那里大約待了三個小時，然后被送回了家。

TO THIS DAY (6 years later) He is still paying this little trip to the ER off! A collections agency came after him and ruined his credit unless he would pay $700/month towards a $12k debt to the hospital!!!! Wtf did they do in 3 hours that equals $12,000.00 dollars. FUCK YOU USA HEALTHCARE YOU TAKE ADVANTAGE OF PEOPLE WHO DONT HAVE INSURANCE

直到今天（6年后），他仍在償還這次急診的費用！一家催收機構找上了他，除非他每月向醫(yī)院支付700美元以償還12,000美元的債務，否則他的信用就會被毀掉?。?！他們在3個小時里做了什么，竟然值12,000美元。去你的美國醫(yī)療體系，你們在剝削那些沒有保險的人。

He got his payments down to $350 using like a money management company who negotiated and got the monthly payment down and even that is very expensive it’s more than his truck payment. He regrets ever going to the hospital that day. It ruined his credit score like A LOt since he was 24 he is now 30 and just getting his life together. The $12k really held him back.

他通過一家資金管理公司協商，將付款降至350美元，即便如此，這筆費用仍然非常昂貴，甚至超過了他的卡車付款。他后悔那天去醫(yī)院。那次經歷極大地損害了他的信用評分，從24歲到30歲，他一直在努力讓生活重回正軌。那1.2萬美元真的拖累了他。

Frank Vaughan
My wife and I had employer provided healthcare insurance. She got diagnosed with stage 4 breast cancer at age 52 and passed away 3 years later. She stayed working as long as possible to keep her insurance in force. The US system is a piecemeal labryinth. After it was all done I was let with over $200K in uncovered expenses. For instance, once diagnosed with cancer tumors in her brain, the insurance company denied coverage for chemo. Each chemo treatment was $18K every 2 weeks. The denials took almost 6 months to process and no one let us know. She had three surgeries and the anethesiologist on each one was not in network so had to pay the full bill ourselves. People here go bankrupt even if the have insurance.

我和我的妻子有雇主提供的醫(yī)療保險。她在52歲時被診斷出患有第四期乳腺癌，并在三年后去世。她盡可能長時間地工作以保持她的保險有效。美國的醫(yī)療系統是一個零散的迷宮。當一切結束后，我留下了超過20萬美元的未覆蓋費用。例如，一旦她被診斷出腦部有腫瘤，保險公司就拒絕支付化療費用。每次化療每兩周需要1.8萬美元。拒絕的決定花了近六個月的時間處理，而且沒有人通知我們。她進行了三次手術，每次手術的麻醉師都不在保險網絡內，所以我們不得不自己支付全額費用。即使有保險，這里的人們也會破產。

Dianne Mclaren-Brighton
I have fairly good insurance. Back in mid September, I twisted my knee while walking my mother's dog. After waiting a few days to see if it would get better, I made an appointment to see my doctor ($20 copay) who diagnosed a torn meniscus and sent me to physical therapy. After two visits a week for three weeks ($25 copay per session), the physical therapist stopped treatment and sent me back to the doctor because I wasn't getting any better. This was in mid October. My doc (another $20 copay) sent me to get an MRI (copay unknown at this time, but it will be a ridiculous amount). The MRI appointment is scheduled for the 19th of November, almost as month after I made the appointment. That was the earliest I could get. If I need to see an orthopedic doctor (copay unknown but definitely over $100 since it's a specialist), it will take at least two, maybe three weeks to get an appointment. If I need surgery, it won't happen until early to mid January. I haven't met our deductible for this year, so I'm on the hook for a couple thousand dollars for the rest of this year. A surgery in January means I have to start over with the deductible. After surgery, there will be another round of physical therapy at $25 a session. So, a simple twisted knee will cost me four months of pain and several thousand dollars of copays and deductibles. Only in America.

我的保險還不錯。九月中旬，我在遛我媽媽的狗時扭傷了膝蓋。等了幾天后，發(fā)現情況沒有好轉，于是預約了醫(yī)生（自付20美元），醫(yī)生診斷為半月板撕裂，并建議我去做物理治療。每周兩次，持續(xù)了三周（每次自付25美元），物理治療師因為我沒有好轉而停止了治療，并讓我回去看醫(yī)生。這是十月中旬的事。我的醫(yī)生（又自付20美元）讓我去做核磁共振（自付金額目前未知，但肯定是一筆不小的數目）。核磁共振預約在11月19日，幾乎是在我預約后一個月。這是我能預約到的最早時間。如果我需要看骨科醫(yī)生（自付金額未知，但肯定超過100美元，因為是?？漆t(yī)生），至少需要兩到三周才能預約到。如果我需要手術，最早也要到一月中旬。我今年的免賠額還沒有達到，所以今年剩下的時間我要自付幾千美元。一月份的手術意味著我要重新開始計算免賠額。手術后，還要再進行一輪物理治療，每次自付25美元。所以，一次簡單的膝蓋扭傷將讓我經歷四個月的痛苦和幾千美元的自付費用。只有在美國才會這樣。

Tessa Wolf
I'll answer with a story.

我會用一個故事來回答。

My father had pancreatic cancer, and after many surgeries and losing 60% of his pancreas, he survived. That was six years ago.

我父親曾患有胰腺癌，經過多次手術并失去了60%的胰腺后，他活了下來。那是六年前的事了。

Two months ago he started presenting with odd symptoms and they were concerned that his cancer had returned. Of course this would be horrible news because aside from everything else, there would be no more pancreas to take. It would basically be a death sentence. We had to schedule something called an MRCP, which is a specialized MRI that focuses on the pancreas.

兩個月前，他開始出現一些奇怪的癥狀，他們擔心他的癌癥復發(fā)了。當然，這將是可怕的消息，因為除了其他一切，已經沒有更多的胰腺可以切除了。這基本上就是死刑。我們不得不安排一種叫做MRCP的檢查，這是一種專門針對胰腺的核磁共振成像。

It was denied by insurance immediately, their excuse was that he didn't need it. Of course he needed it, so we had to file paperwork for an appeal to get a prior authorization code so that we could bypass the system and have it properly submitted to insurance. Because we had to do all of these things, it took about a month before we had the code and we could schedule the MRCP.

保險公司立即拒絕了，他們的借口是他不需要這個。當然他需要，所以我們不得不提交文件進行上訴，以獲得事先授權代碼，以便我們可以繞過系統并正確提交給保險公司。因為我們必須做所有這些事情，所以花了大約一個月的時間才拿到代碼，我們才能安排MRCP。

Graham
I live in New Brunswick, Canada and am a low income senior. My drug plan is totally free for me so long as I'm collecting Guaranteed Income Supplement and my basic health insurance is $22 a month. I pay $5.05 per prescxtion up to a 3 month supply. I pay nothing to see ANY doctor. I'm a cancer patient and need salvage therapy. Again, zero cost to even stay at the hospital for 5 weeks of radiation. The only things I would have to pay anything for are non-medically required items like an annual check-up which would cost $40.

我住在加拿大新不倫瑞克省，是一名低收入老年人。只要我領取保障收入補助，我的藥物計劃就完全免費，我的基本健康保險每月22加元。每張?zhí)幏轿抑Ц?.05加元，最多可供應3個月。我看任何醫(yī)生都不需要支付任何費用。我是一名癌癥患者，需要挽救治療。再次強調，即使住院進行5周的放射治療，我也不需要支付任何費用。我唯一需要支付的是非醫(yī)療必需的項目，比如年度體檢，費用為40加元。

My American girlfriend is also a cancer patient. She is on disability Medicare. However, she is now so far in debt she'd never be able to pay…well into the 6 figures.

我的美國女友也是一位癌癥患者。她享有殘疾醫(yī)療保險。然而，她現在負債累累，根本無法償還……債務已經高達六位數。

Is the US good? They may have good hospitals but the actual healthcare is below average developed world standards. You have only 2 politicians who will do something about it…Bernie and Elizabeth. Democratic Socialism is NOT Communism. It is far from it. The US already has many social democratic features…roads, fire and police departments, Medicare, the VA, etc.

美國好嗎？他們可能有好的醫(yī)院，但實際的醫(yī)療水平低于發(fā)達國家的平均水平。你們只有兩位政客會為此做點什么……伯尼和伊麗莎白。民主社會主義不是共產主義。它遠非如此。美國已經有許多社會民主的特征……道路、消防和警察部門、醫(yī)療保險、退伍軍人事務部等。

Medicare for All, otherwise known as Universal Healthcare or Single Payer, is the only way to repair the US system. It really is simple. You pay very minimal co-pays on prescxtions, but you don't pay a thing for virtually anything else. You will have to get, either through your employer or privately, supplemental insurance which will cost $20 to $60 per month…private will cost more…which covers non-medically necessary things like glasses, crutches, walkers, some home care, etc. Under Bernie's plan, many of these things will be covered as well.

全民醫(yī)療保險，也被稱為全民醫(yī)療或單一支付者，是修復美國醫(yī)療體系的唯一途徑。這其實很簡單。你在處方藥上只需支付很少的共付額，但幾乎其他所有東西都不用支付。你必須通過雇主或私人方式獲得補充保險，每月費用在20到60美元之間……私人保險會更貴……這些保險涵蓋非醫(yī)療必需的東西，如眼鏡、拐杖、助行器、一些家庭護理等。在伯尼的計劃下，許多這些東西也將被涵蓋。

Yes, you will pay a little more in taxes but far less in total than half than what you're paying now in co-pays, deductibles, and insurance. If you lose your job you still have full healthcare and hospitalization at NO CHARGE. There's no more falling through the cracks, no networks, no bill collectors, no checking at the door for insurance coverage, no dying because you can't afford a doctor or hospital. Please, don't listen to Republican lies. They're only protecting the rich.

是的，你將在稅收上多支付一些，但總體上比你現在支付的共付額、免賠額和保險費用少得多。如果你失業(yè)了，你仍然可以免費享受全面的醫(yī)療和住院服務。不再有遺漏，沒有網絡限制，沒有討債人，沒有在門口檢查保險覆蓋范圍，沒有因為負擔不起醫(yī)生或醫(yī)院而死亡。請不要聽信共和黨的謊言。他們只是在保護富人。

And, as far as prescxtion medication is concerned, ours is so much cheaper. My girlfriend was on Xeralto and, when January happened, her deductable popped up. After insurance, it was going to be $460. The exact same prescxtion here in NB AT FULL PRICE is under $100. Are you being ripped off? Of course you are. You have the only FOR PROFIT system in the developed world.

而且，就處方藥而言，我們的價格要便宜得多。我的女朋友在使用Xeralto，當一月份到來時，她的免賠額出現了。在保險之后，費用將是460美元。而在新不倫瑞克省，同樣的處方藥，全價也不到100美元。你是否被宰了？當然是的。你擁有的是發(fā)達世界中唯一的以營利為目的的醫(yī)療體系

Mariluz 8a
My sister in law Judy is a GP in Spain. She’s also a professional-level complainer, if you listen to her you’ll get the notion that nothing in the system works. Last week she was complaining about not having paper records in her office; our regional healthcare service went off-paper more than ten years ago, the horror, how dare they.

我的嫂子朱迪在西班牙是一名全科醫(yī)生。她也是一個專業(yè)級別的抱怨者，如果你聽她說話，你會覺得系統中的一切都不起作用。上周她還在抱怨她的辦公室里沒有紙質記錄；我們地區(qū)的醫(yī)療服務在十多年前就實現了無紙化，真是可怕，他們怎么敢這樣。

Several years ago she was horrified about a case they’d studied in a medical congress. Remember the Nile virus scare? The case was about a 42yo patient whose treatment had accumulated more medical errors than she’s seen in 25 years of medical school, residency and job. The delays due to paperwork crap alone were unthinkable: things such as “different services in the same hospital are actually different businesses, so taking a specific scan took three days just to process the paperwork and authorizations”. The patient ended in a wheelchair and with a list of symptoms that in Spain would have given him access to getting a basic chair and a motorized bed from the healthcare system (a better chair can be rented or bought), free visits from nurses several times per week…

幾年前，她在一次醫(yī)學大會上研究的一個案例讓她感到震驚。還記得尼羅河病毒的恐慌嗎？這個案例是關于一名42歲的患者，他的治療過程中累積的醫(yī)療錯誤比她25年的醫(yī)學院學習、實習和工作中所見的還要多。僅僅因為文書工作導致的延誤就令人難以置信：例如“同一家醫(yī)院的不同部門實際上是不同的業(yè)務，因此進行一次特定的掃描需要三天時間來處理文書和授權”?；颊咦罱K坐上了輪椅，并出現了一系列癥狀，在西班牙，這些癥狀本可以讓他從醫(yī)療系統中獲得一把基本輪椅和一張電動床（更好的輪椅可以租用或購買），每周幾次的護士免費探訪……

What I don’t ever expect to tell Judy is that I happen to know that man’s WIDOW. I know that he lost his job due to his illness. I know that she lost her job due to his illness, as well. I know they lost their home. I know that one day she got home and found him dead of complications, not from Nile, but from the other illnesses he caught while hospitalized.

我從未期望告訴朱迪的是，我恰好認識那個男人的遺孀。我知道他因為生病而失去了工作。我也知道她因為他的病而失去了工作。我知道他們失去了家園。我知道有一天她回到家，發(fā)現他死于并發(fā)癥，不是尼羅河，而是他在住院期間感染的其他疾病。

I know that in Spain he would have been autopsied. I know that in the US she had to beg for money to bury him.

我知道在西班牙，他會被進行尸檢。我知道在美國，她不得不乞討錢來埋葬他。

I don’t know, is that bad?

我不知道，這很糟糕嗎？

Alvin Grissom II
When I was in my twenties, I had to get questionable short-term health insurance in between jobs because no insurance company would cover me due to mild, undiagnosed symptoms. (I now know they were food allergies.)

在我二十多歲的時候，由于輕微的、未確診的癥狀（我現在知道是食物過敏），沒有保險公司愿意為我提供保險，所以我不得不在工作之間購買有問題的短期健康保險。

At one point, I was having heart palpitations, so I went to a cardiologist for examination. (I know now that the culprit was again food allergies.) They did some basic stress tests and observations of my heart. The pre-insurance bill was in the range of $60,000.

有一次，我出現了心悸的癥狀，于是我去看了心臟病專家進行檢查。（我現在知道罪魁禍首又是食物過敏。）他們做了一些基本的心臟壓力測試和觀察。保險前的賬單在6萬美元左右。

I had to have surgery on my shoulder after a skating accident in my early 30s. I had the graduate student health insurance, which constantly fought with my healthcare provider about covering basic services. It was so bad that the administrator actually called the insurance company over the phone while I sitting was next to them to get to them to follow through.

我在30歲出頭時因滑冰事故不得不進行肩部手術。我當時有研究生健康保險，但它經常與我的醫(yī)療服務提供者就基本服務的覆蓋問題發(fā)生爭執(zhí)。情況非常糟糕，以至于管理員實際上在我坐在旁邊時打電話給保險公司，要求他們履行承諾。

This was a 30 minute routine surgery to fix a chronically dislocating shoulder. Without insurance, it would have cost, if memory serves, over $50,000. I (by which I mean my parents, because I didn’t have this kind of money as a grad student) had to pay about $6,000 of that.

這是一個30分鐘的常規(guī)手術，用于修復長期脫臼的肩膀。如果沒有保險，據我記憶，費用將超過50,000美元。我（這里指的是我的父母，因為作為研究生我沒有這么多錢）不得不支付其中的大約6,000美元。

These are just two examples.

這僅僅是兩個例子。

MamaSquid
It’s that bad even if you DO have insurance. We have insurance - really good insurance — but our healthcare costs are about $20,000 a year including premiums. I have an insured friend who lost about $50,000 out of pocket when she got cancer. Health care is one of the most broken things about the US, and one of the most unjust things, since people who don’t have a lot of means are more likely to suffer chronic illness and frequent hospitalizations. So the less money you have, and the sicker you are, the more you have to spend on healthcare. Pretty twisted.

即使你有保險，情況也很糟糕。我們有保險——非常好的保險——但我們的醫(yī)療費用每年大約為2萬美元，包括保險費。我有一個有保險的朋友，她得了癌癥后自掏腰包損失了大約5萬美元。醫(yī)療保健是美國最糟糕的事情之一，也是最不公正的事情之一，因為經濟條件不好的人更有可能患上慢性病并頻繁住院。所以，你越沒錢，病得越重，你不得不在醫(yī)療保健上花費的錢就越多。這真的很扭曲。