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I am under Blue Cross/Blue Shield PPO. Even I am treated in out-of-network hospital, I am just responsible for 30% of the charges. And the annual deductible is capped at $2,500. After that the insurance carrier pays 100% of the charges.
I have close friends and relatives in UK and Canada. In UK, my sister has to buy extra insurance to get additional coverage due to her old age. In Canada, for non-urgent surgery like cataract and colonoscopy, the patient has to wait -- sometimes up to years. And in both UK and Canada, the patient has to go through their family doctor first in order to see a specialist.
For PPO plan in US, I can see any doctor anywhere I like (so far I have seen only one doctor who is not affiliated with Blue Cross/Blue Shield). In fact, I have written a post under another topic regarding how I suddenly had retinal detachment in NYC, the retinal specialist I saw in NJ right away booked an appointment for me with the retinal specialist in Honolulu for surgery.
I don't think those health plans in UK or Canada will react so swiftly for such cases or even allow the patient to do that (i.e. mandate the patient to see the family doctor first). Neither does the HMO plan in this country (IMO HMO plan is real junk).
Just to give you an example of how ridiculous, corrupt, dangerous, unethical, financially deadly and borderline insane US healthcare has become, take a look at some of the articles on the recent hideous case of Heather Bresch, the CEO of Mylan Pharmaceuticals which jacked up the cost of the epi-pen to $600, even though this is a very old and well-established medicine, the device costs about a couple bucks to make and in the past has cost a few bucks in the US thanks to its very old technology. (The anaphylaxis principle and epinephrine to treat it were discovered by some scientist in Germany over a century ago-- not one bit of "pharmaceutical innovating" here).
In Europe, Canada, South America and I suspect all of Asia, they have generic forms of the epi-pen available that, indeed, cost a mere pittance because the governments and communities actually work in the interests of these countries' citizens instead of corrupt and borderline insane crony capitalists like Bresch-- who BTW is the wife of a lobbyist and the daughter of US Senator Joe Manchin of West Virginia, who has conveniently been active in using government power (through the FDA) to get another epi-pen supplier off the market and block another supplier from FDA approval, thus giving his daughter's company a monopoly while disallowing price controls. I find it funny when some US media like to point fingers at countries in Asia and South America and say, "oh, look at how corrupt and nepotistic they are, the government is in cahoots with insider companies run by the families of major officials" when in reality, such official mass corruption, crony capitalism and nepotism are now standard fare in the United States, esp. in healthcare. (The Mylan case is just tip of the iceberg of cases that actually get media attention). This is what's allowed Heather Bresch to price-gouge on a cheap and essential medicine, just like Martin Shkreli did before (and Shkreli was indicted for issues totally unrelated to the price-gouging, which has continued without restraint).
Since the epi-pen must be constantly carried and refreshed, this outrageous price-gouging imposes a severe burden on the families of people with kids who need the epi-pens, as well as on schools and localities that must carry the epi-pens on their premises, AND it causes a major increase in insurance premiums for the affected communities which must absorb the millions and millions of dollars in outrageously increased costs for an essential medicine that Europeans, Canadians, South Americans and likely Asians can get for 1% of the cost in the USA (again, this is why their overall taxes are lower than the US even though they get better services, they don't have crony capitalists like Bresch gaming the system). And the epi-pen is not an optional medication, it's needed by people, especially kids, who have allergies and can go into anaphylactic shock due to something like a bee sting or food allergy.
I'll say that again so it clearly sinks in: If the kids with these allergies don't have their epi-pen on them at all times, ready to use at all times, with the supply fresh (the epinephrine goes bad easily and has to be constantly replaced), and suffer even a minor bee sting, the kids will die on the spot. That's how serious anaphylaxis is, so this medication is not a luxury but an absolute, constant necessity. I know this personally because my niece has such allergies, and on even short hiking trips that we took in Texas, we had to make absolutely, 100% certain that she had her epi-pen, that it was working and that the supply was fresh to use in an emergency. The epi-pen is so important that schools now carry it too.
But thanks to the corrupt and filthy crony capitalist monopoly that Bresch's US Senator Daddy has helped to arrange for his daughter's company, Epi-Pen patients and school districts are now totally at the mercy of a price-gouging vulture, and the US government is powerless (or even complicit) in allowing this to continue. Oh, and Bresch is hardly an icon of US meritocracy or achievement either. Her background? She basically failed out of the West Virginia University Business School, never even having completed the credits, but then once again thanks to Daddy Senator's nepotism and string pulling, she got her MBA a decade later.
The epi-pen price gouging is causing severe hardship for a lot of Americans in communities. Even those who are comfortably middle class are getting hit hard by the extra costs, which take the form of additional co-pays, deductibles and co-insurance costs, while premiums for nearly everyone are pushed way up. (And this is even before we get into the outrageous costs of US health insurance in general, with CEO's like William Mcguire of United HealthCare making hundreds of millions of dollars in a job where he basically goes on paid junkets to lobby and bribe members of Congress to keep the crony capitalism and corruption of US healthcare going). It's like being hit with an extra mortgage for a well-established med that's been in generic use for decades.
So to summarize this, the epi-pen scandal is just a tip of the iceberg case of what US healthcare has become-- a mix of massive corruption, price-gouging, crony capitalism, nepotism, a controlled market that's the worst of both worlds (no price controls on drugs like in Europe, but also no free market capitalistic competition thanks to the nepotistic assistance of insiders, like Bresch's Senator Daddy, who help favored companies to keep monopolies) and brutal exploitation of American consumers and communities. And there's little if any prospect of reform since this afflicts both parties-- Bresch's Senator father is a Democrat (and Mylan has contributed to the Clinton Foundation), while many Republicans in Congress also support this sort of crony capitalism, so both parties are in on the scam.
Contrast this with Europe, Canada, South America and I suspect Asia, where critical medications like the epi-pen are available for a couple bucks at most, where the governments advocate for the consumer to keep the cost low and where there's real free market capitalism and competition to make sure the costs stay low. I have a distant relative who shuttles between France, Belgium, Netherlands and Italy right now for work, who also has a child with allergies that require an Epi-Pen. He pays virtually nothing out of pocket for this low-cost, lifesaving medication, and his taxes even in France are actually lower than they were in the USA with all the taxes factored in (state and property taxes are very high in the US and much higher than those taxes in Europe). So he's actually making more money, paying less taxes and getting much better health care for his son in Europe than in the US, while my sister in Texas is dealing with mounting financial hardship to make sure her daughter survives a simple bee sting with technology that's been around for decades. And by-the-way the outrageous costs that Bresch has mandated for the epi-pen don't go to "fund research or innovation"-- she's a loser who failed out of a mediocre business school without one innovative bone in her body, the extra costs go right into her pocket and those of her Senator Daddy. Whereas Europe in both the government funded public sector and its private sector companies, does a lot more real research and innovation for new treatments. (Per capita Switzerland for ex. does far more research and brings far more lifesaving drugs to market than the USA). And all this corruption and nepotism aren't happening in some "3rd world banana republic" like Venezuela that US media is always trying to propagandize against (or American guys like Ryan Lochte are making up lies out of thin air about), it's happening right here, in the United States of America.
I simply can't see how anyone rational person can defend the US health care system with outrages like this going on constantly, which are hardly isolated cases. And if you've been comfortable enough to avoid such cases, congrats on being lucky so far. One day your luck will change-- that's the nature of health care-- and you and your family will need medical assistance, and this sort of price-gouging and corruption will hit you hard. For that matter, the Heather Bresch case also makes a big ugly mockery about all the propaganda of the US being a meritocracy, which I suspect would be especially infuriating to Asian-Americans without the kind of nepotistic benefits that someone like Bresch enjoys. The outrages being pushed by Bresch and the amount of money she's made by her monopolistic corruption and crony capitalism show that the real way to success in America isn't by merit or accomplishment anymore, it's by having insider connections to rich and prominent people in power. It's like saying to Asian-Americans, "forget about all your hard work and Ivy League degrees, the real way to get ahead in America is to already have a link to someone in power, y'all are just suckers, but thanks for drinking our propaganda Kool-Aid and paying taxes to the same corrupt government that exploits you and other people who actually believe in meritocracy". While I don't know a whole lot about how health care is structured in Asia, I have a hard time believing they'd allow this sort of stupidity, and for all the claims and US media propaganda about nepotism and corruption in Asia, it looks like the USA is setting the pace for nepotism and corruption with cases like this.
Last edited by Corascant; 08-30-2016 at 02:31 PM..
The corruption in pharmaceutical industry in U.S. that you mentioned is quite irrelevant in Asia. With the exception of Japan, home-grown pharmaceutical industry, which requires input of multi-billion investment, is practically non-existent in Asia.
Well a poor white person certainly isn't going to Asian expecting to work their way up the elite class in Asia. It's all about white males with Asian women with you isn't it? Whites bad, Asians good everywhere they go, and what ever they do, right?
I call out hypocrisy when and where I see it, and the most blatant hypocrisy in the world today are alt-right racists, race realists, white supremacists, etc., hooking up with non-white women because white women can't stand them. On the other hand, you obsess over the plight of white males all the time. Whites good, everyone else bad right?
I call out hypocrisy when and where I see it, and the most blatant hypocrisy in the world today are alt-right racists, race realists, white supremacists, etc., hooking up with non-white women because white women can't stand them. On the other hand, you obsess over the plight of white males all the time. Whites good, everyone else bad right?
It's dubious when and where you see hypocrisy. That's just your fantasy and false labeling of conservatives who happen to be white with no real proof. Even if there were a few cases like that, it wouldn't necessarily be hypocrisy. A person could be a lookist, but out of necessity "hook up" with a woman he finds unattractive. That's not hypocrisy, it's settling. Yes I consider the plight of whites in America among other things just as you obsess over white males with Asian females and how bad you think most white people are.
You don't tell the truth. Most white guys including "alt-right" that pair with Asian women are attracted to them and some think Asians are superior or a better choice than white, western women and vice versa. It takes two to tango and it's a voluntary, but you never have negative commentary on why Asian women do it ?
Though it is off topic, I like to write a post on White guy marrying Asian girl.
Maybe on Mainland the ratio is more lopsided with more White guys marrying Asian girls, I can't tell in Hawaii because my neighbor is an Asian guy who married a White girl. Same with my co-worker.
As long as they are in love with each other, I don't see why race is an issue.
Other than that, Asian guy and White guy are usually looking for different types of girls. For example, most White guys perceive Lucy Liu as really pretty. But for Asian guys I know, almost everyone thinks Lucy Liu is very unappealing or outright ugly.
So in fact Asian guy and White guy are after different categories of Asian girls. There is no conflict at all.
And if an Asian guy is upset because his Asian girlfriend is stolen by a White guy, there is a remedy.
Just go to any Asian countries to look for girl friends. In most Asian countries, there is an over-abundance of marriageable girls. Even in China where guys outnumber girls, it is still pretty easy for an Asian American guy to look for a girl friend there.
And in most cases, the girl you find in Asia will be much more better than the one you had in U.S.
Though it is off topic, I like to write a post on White guy marrying Asian girl.
Maybe on Mainland the ratio is more lopsided with more White guys marrying Asian girls, I can't tell in Hawaii because my neighbor is an Asian guy who married a White girl. Same with my co-worker.
As long as they are in love with each other, I don't see why race is an issue.
Other than that, Asian guy and White guy are usually looking for different types of girls. For example, most White guys perceive Lucy Liu as really pretty. But for Asian guys I know, almost everyone thinks Lucy Liu is very unappealing or outright ugly.
So in fact Asian guy and White guy are after different categories of Asian girls. There is no conflict at all.
And if an Asian guy is upset because his Asian girlfriend is stolen by a White guy, there is a remedy.
Just go to any Asian countries to look for girl friends. In most Asian countries, there is an over-abundance of marriageable girls. Even in China where guys outnumber girls, it is still pretty easy for an Asian American guy to look for a girl friend there.
And in most cases, the girl you find in Asia will be much more better than the one you had in U.S.
Just to give you an example of how ridiculous, corrupt, dangerous, unethical, financially deadly and borderline insane US healthcare has become, take a look at some of the articles on the recent hideous case of Heather Bresch, the CEO of Mylan Pharmaceuticals which jacked up the cost of the epi-pen to $600, even though this is a very old and well-established medicine, the device costs about a couple bucks to make and in the past has cost a few bucks in the US thanks to its very old technology. (The anaphylaxis principle and epinephrine to treat it were discovered by some scientist in Germany over a century ago-- not one bit of "pharmaceutical innovating" here).
In Europe, Canada, South America and I suspect all of Asia, they have generic forms of the epi-pen available that, indeed, cost a mere pittance because the governments and communities actually work in the interests of these countries' citizens instead of corrupt and borderline insane crony capitalists like Bresch-- who BTW is the wife of a lobbyist and the daughter of US Senator Joe Manchin of West Virginia, who has conveniently been active in using government power (through the FDA) to get another epi-pen supplier off the market and block another supplier from FDA approval, thus giving his daughter's company a monopoly while disallowing price controls. I find it funny when some US media like to point fingers at countries in Asia and South America and say, "oh, look at how corrupt and nepotistic they are, the government is in cahoots with insider companies run by the families of major officials" when in reality, such official mass corruption, crony capitalism and nepotism are now standard fare in the United States, esp. in healthcare. (The Mylan case is just tip of the iceberg of cases that actually get media attention). This is what's allowed Heather Bresch to price-gouge on a cheap and essential medicine, just like Martin Shkreli did before (and Shkreli was indicted for issues totally unrelated to the price-gouging, which has continued without restraint).
Since the epi-pen must be constantly carried and refreshed, this outrageous price-gouging imposes a severe burden on the families of people with kids who need the epi-pens, as well as on schools and localities that must carry the epi-pens on their premises, AND it causes a major increase in insurance premiums for the affected communities which must absorb the millions and millions of dollars in outrageously increased costs for an essential medicine that Europeans, Canadians, South Americans and likely Asians can get for 1% of the cost in the USA (again, this is why their overall taxes are lower than the US even though they get better services, they don't have crony capitalists like Bresch gaming the system). And the epi-pen is not an optional medication, it's needed by people, especially kids, who have allergies and can go into anaphylactic shock due to something like a bee sting or food allergy.
I'll say that again so it clearly sinks in: If the kids with these allergies don't have their epi-pen on them at all times, ready to use at all times, with the supply fresh (the epinephrine goes bad easily and has to be constantly replaced), and suffer even a minor bee sting, the kids will die on the spot. That's how serious anaphylaxis is, so this medication is not a luxury but an absolute, constant necessity. I know this personally because my niece has such allergies, and on even short hiking trips that we took in Texas, we had to make absolutely, 100% certain that she had her epi-pen, that it was working and that the supply was fresh to use in an emergency. The epi-pen is so important that schools now carry it too.
But thanks to the corrupt and filthy crony capitalist monopoly that Bresch's US Senator Daddy has helped to arrange for his daughter's company, Epi-Pen patients and school districts are now totally at the mercy of a price-gouging vulture, and the US government is powerless (or even complicit) in allowing this to continue. Oh, and Bresch is hardly an icon of US meritocracy or achievement either. Her background? She basically failed out of the West Virginia University Business School, never even having completed the credits, but then once again thanks to Daddy Senator's nepotism and string pulling, she got her MBA a decade later.
The epi-pen price gouging is causing severe hardship for a lot of Americans in communities. Even those who are comfortably middle class are getting hit hard by the extra costs, which take the form of additional co-pays, deductibles and co-insurance costs, while premiums for nearly everyone are pushed way up. (And this is even before we get into the outrageous costs of US health insurance in general, with CEO's like William Mcguire of United HealthCare making hundreds of millions of dollars in a job where he basically goes on paid junkets to lobby and bribe members of Congress to keep the crony capitalism and corruption of US healthcare going). It's like being hit with an extra mortgage for a well-established med that's been in generic use for decades.
So to summarize this, the epi-pen scandal is just a tip of the iceberg case of what US healthcare has become-- a mix of massive corruption, price-gouging, crony capitalism, nepotism, a controlled market that's the worst of both worlds (no price controls on drugs like in Europe, but also no free market capitalistic competition thanks to the nepotistic assistance of insiders, like Bresch's Senator Daddy, who help favored companies to keep monopolies) and brutal exploitation of American consumers and communities. And there's little if any prospect of reform since this afflicts both parties-- Bresch's Senator father is a Democrat (and Mylan has contributed to the Clinton Foundation), while many Republicans in Congress also support this sort of crony capitalism, so both parties are in on the scam.
Contrast this with Europe, Canada, South America and I suspect Asia, where critical medications like the epi-pen are available for a couple bucks at most, where the governments advocate for the consumer to keep the cost low and where there's real free market capitalism and competition to make sure the costs stay low. I have a distant relative who shuttles between France, Belgium, Netherlands and Italy right now for work, who also has a child with allergies that require an Epi-Pen. He pays virtually nothing out of pocket for this low-cost, lifesaving medication, and his taxes even in France are actually lower than they were in the USA with all the taxes factored in (state and property taxes are very high in the US and much higher than those taxes in Europe). So he's actually making more money, paying less taxes and getting much better health care for his son in Europe than in the US, while my sister in Texas is dealing with mounting financial hardship to make sure her daughter survives a simple bee sting with technology that's been around for decades. And by-the-way the outrageous costs that Bresch has mandated for the epi-pen don't go to "fund research or innovation"-- she's a loser who failed out of a mediocre business school without one innovative bone in her body, the extra costs go right into her pocket and those of her Senator Daddy. Whereas Europe in both the government funded public sector and its private sector companies, does a lot more real research and innovation for new treatments. (Per capita Switzerland for ex. does far more research and brings far more lifesaving drugs to market than the USA). And all this corruption and nepotism aren't happening in some "3rd world banana republic" like Venezuela that US media is always trying to propagandize against (or American guys like Ryan Lochte are making up lies out of thin air about), it's happening right here, in the United States of America.
I simply can't see how anyone rational person can defend the US health care system with outrages like this going on constantly, which are hardly isolated cases. And if you've been comfortable enough to avoid such cases, congrats on being lucky so far. One day your luck will change-- that's the nature of health care-- and you and your family will need medical assistance, and this sort of price-gouging and corruption will hit you hard. For that matter, the Heather Bresch case also makes a big ugly mockery about all the propaganda of the US being a meritocracy, which I suspect would be especially infuriating to Asian-Americans without the kind of nepotistic benefits that someone like Bresch enjoys. The outrages being pushed by Bresch and the amount of money she's made by her monopolistic corruption and crony capitalism show that the real way to success in America isn't by merit or accomplishment anymore, it's by having insider connections to rich and prominent people in power. It's like saying to Asian-Americans, "forget about all your hard work and Ivy League degrees, the real way to get ahead in America is to already have a link to someone in power, y'all are just suckers, but thanks for drinking our propaganda Kool-Aid and paying taxes to the same corrupt government that exploits you and other people who actually believe in meritocracy". While I don't know a whole lot about how health care is structured in Asia, I have a hard time believing they'd allow this sort of stupidity, and for all the claims and US media propaganda about nepotism and corruption in Asia, it looks like the USA is setting the pace for nepotism and corruption with cases like this.
TL; DR
Really, you've got to be a bit less wordy with your posts, which has been a pattern here.
Try to stay on topic. And as I've said, yes, health care is a big issue in the USA. However, w/r/t returnees to Asia, that probably ranks way down on the list compared with professional opportunities and career growth being number one.
Really, you've got to be a bit less wordy with your posts, which has been a pattern here.
Try to stay on topic. And as I've said, yes, health care is a big issue in the USA. However, w/r/t returnees to Asia, that probably ranks way down on the list compared with professional opportunities and career growth being number one.
I was responding to another poster who was discussing this specific topic, and who seemed to be trivializing (or at least was not aware of) the tangible human damage done by the USA's utterly barbaric and thoroughly corrupt system of health care access and insurance over several posts, hence the extended response. (And there's so much horribleness in that system that a detailed post will cover a lot of angles). So here's a TL;DR for you: The disastrous US healthcare system is literally killing kids whose families can't afford basic medications like an epipen, and bankrupting millions more for basic healthcare needs (even middle and upper class Americans those with good health habits and insurance), something that simply does not happen in Europe, Canada or any other industrialized country, and thus represents a fundamental failing of the USA as a first-world society.
I actually agree with you from my observations that it's not such a major factor for Asians returning to Asia, though it seems to be at least a significant consideration for Americans going to work in Europe-- esp for entrepreneurs, professionals and those in creative fields, for them the US healthcare system more and more poses insurmountible financial hurdles since they have to basically buy on the open market and the insurance cos. and providers tend to wring them for every nickel and dime, whereas in Europe they can focus more on growing their businesses. That's the little caveat here, I sense maybe most returning Asian-Americans don't think so much consciously about the healthcare issue, but if they're trying to run a business or strike out on their own, then the ravenous money-devouring jaws of the US healthcare mess clearly hurt them, so this policy mess probably is having at least an indirect effect.
The corruption in pharmaceutical industry in U.S. that you mentioned is quite irrelevant in Asia. With the exception of Japan, home-grown pharmaceutical industry, which requires input of multi-billion investment, is practically non-existent in Asia.
That isn't the point-- the point is the effect of such massive corruption and crony-style capitalism (not just in Pharma but in health insurance, hospital exec offices and the bought-off politicians who take their bribes) on damaging the health and well-being of Americans as a whole. It doesn't particularly matter where the pharma co's are hq'ed-- and most of the worst cases are indeed American, like Mylan with the epi-pen-- what does matter is that the US's healthcare system is so corrupt and disconnected from basic reality and economics in America, that it's literally killing millions of Americans, and bankrupting millions more. Even from the middle and upper classes-- almost all medical bankruptcies aren't among "uninsured deadbeats", they hit insured people, even among those in the upper class, who get hit by a nasty illness or injury that could hit anybody (like injures from a car accident or a violent robbery), who then suffer hundreds of thousands of dollars in medical bills due to the all the stupid quirks and gaps in US healthcare and the outrageous costs. This does not happen in any other industrialized country in Europe, Asia or South America. It doesn't even happen in most developing countries with respect to such basic care. It's a uniquely American policy failing, and an embarrassing one since it would be so easy to fix if not for the USA's broken political system and the corruption that's so common in it.
For an even more potent example of how literally deadly the US healthcare system has become to it's own citizens, here's a frightening chart showing how in the United States-- alone among all industrialized countries (and even compared to many developing countries)-- Americans have actually had an increasing death rate of younger adults, decreased life expectancy and overall decreased health over the past 15 years, especially compared to European countries like Sweden and France where life expectancy and overall health have improved significantly. This isn't just a minor study either-- it was done by a Nobel prizewinner economist named Angus Deaton and was chosen as top research study of 2015:
This was a remarkable study, the only disappointing thing is that they didn't seem to have similar charts from Asian countries like Korea, Japan, Taiwan, Vietnam, China, India or Thailand, but based on the author's survey of the data from industrialized countries in general, it sounds like health has been improving there too while the USA is alone in having this mortality crisis, which basically sounds like Russia after it went belly-up in the 90's.
This is the most damning evidence to show how corrupt, inhumane, dangerous, incompetent and failed the US healthcare system has become. Yes, part of the increased mortality in the US in recent decades can be explained by terrible health and awful health habits in the USA, especially the high rates of obesity and lack of exercise in US with so many people driving in and out of the suburbs. That's a big problem back in Texas FWIW.
But that can't come close to explaining this phenomenon in general, not only has this health breakdown in the USA killed millions of American citizens, it's also disproportionately striking middle-class and even upper-class Americans who in general have better health habits and lower obesity. (This includes white and Asian-Americans, who aren't shown specifically on the graph but have also had declining health in the US during the period examined). There was originally talk that the victims were mostly poorer Americans addicted to opiates, and while this is a contributor, the follow up studies showed that the middle and upper class communities actually had the highest increases in mortality compared to 20 years ago, and that obesity increases were not the major factor in the higher mortality. OTOH the one thing that has changed for these groups, including middle and upper class Americans, is health care access. Premiums and especially deductibles have gone up so insanely high in America in the past couple decades then even relatively well off Americans have trouble affording healthcare, and whereas the poor at least get healthcare subsidies and access to Medicaid, the middle and upper classes don't have such help even though their healthcare bills can be extremely high. So they get hit harder financially by medical bills, and are more reluctant to use US healthcare even if they're clearly sick or injured.
This shows how ridiculous it is to even talk about things like US GDP as if they're supposed to be a badge of honor-- a supposedly good economy, and even that assumption is questionable when you dig deeper into the numbers, doesn't mean a whole lot of if the health of a country's citizens is declining so severely. It's an empty statistic. Basic health measures like this are the most elemental measures of a country's well being and quality of life, and the USA is falling way behind. And while there may be many reasons for it, the corrupt disaster of the US healthcare system is clearly a major contributing cause.
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