An example of why the US healthcare system is economically broken | Peter Attia

There are many amazing things about the US healthcare system. But it is fundamentally broken from an economic standpoint and this example is sadly all too common.

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The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.

Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.

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[danandlollie]

Nailed it. I've been a practicing ER doc for 20 years and am consistently amazed and disappointed that we continue to live under this system

[ethxo]

When I was in college I seriously injured my back. I was afraid of the debt I’d incur because I didn’t have insurance so I didn’t go. The next week I went to China for study abroad. The pain was so bad I did end up in the hospital.

My back turned out to be fractured. The X Rays, CT scans and treatments all cost me around $100. I’m grateful I waited until I was in China because I’m sure the CT scan alone would have been tens of thousands of dollars.

But just think how many people like myself avoid seeking out treatment out of fear of being unable to pay. Their illnesses get worse requiring more expensive treatments. Frustrating indeed.

[melissasueferrin]

I live in Mexico and broke my ankle at the beginning of April. During the whole process I paid for one x-ray out of pocket because it was after hours at the government clinic. That private x-ray cost about 20 US dollars. That's the only money I spent on the whole process that included surgery.

[brokenarrow]

My wife has MS and I have had several cancer's. The financial impact has been devastating. The amount we pay for insurance and our out of pocket cost are obscene.

[matthewvega]

My daughter had a hospital stay due to dehydration from diarrhea. $10k per night for IV fluids and pain medication. And they said they couldn't figure out what was causing the problem. Every time a family member has been in the hospital it's been some variation on this theme. Yes, broken.

[nedmoore]

Oh nearly the same thing happened to me. Over $5k for a fractured big toe at the emergency room. That’s basically my entire deductible. I’m refusing to pay the absurd amount - for merely wrapping my toe in an ace bandage and an X-ray. Never even put me in a room I was on a gurney in the hall. Complete insanity.

[AnnikaOBrien]

I contracted meningitis and was hospitalized in Los Angeles, they saved my life but the bill was $1.1M - M for Million - went through the bills and many were double and triple charging for the same procedures. Fortunately since I was young and broke the entire bill got paid for by CA taxpayers. I not only didn’t owe anything, I got physical therapy and follow-up appointments with neurologists covered, too. After telling that story to a few other folks I was told that is pretty common in California. It made me wonder if so many people are getting free healthcare, who’s actually paying for it. Now that I’m older, own a home and pay taxes, I see where all the money comes from.

[loc]

I'm in the U.K. My cat had a *bad* immune reaction to some medication and ended up spending 2 weeks at the vets. Emergency treatment including I.V. fluids, several blood tests, food, boarding and several examinations by a doctor who spent longer in training than a hospital M.D. came to a total of ~US$2400.

My cat received more medical attention over a longer period than your son and it cost *less.* That is crazy.

[lucyflores]

We moved from the USA to Belgium a few years ago after realizing how expensive health care would be for our family. There we paid 8K for the natural birth of my son (we had insurance). Here in Belgium, we paid 30 euros for his tonsil removal surgery + placement of ear tubes. It’s really sad how the healthcare system in the USA prioritizes money, and patients cannot do anything about it.

[scooby]

Dr. Attia, one thing we have done is asked for a completely itemized bill, and then asked about anything we don't know what it's for, or that was never used. We've actually been successful in lowering bills that way. I completely agree with your assessment and we have experienced this ourselves, fortunately only several times. The bills were astronomical compared to yours. It's mind bending.

[valarieannaliza]

I was in healthcare (Lab mgmt) in the 90’s when this was all ushered in. Totally illogical…it could never be explained to me. It started when the bean counters took over. Our CEO was an accountant. There was total chaos in the late 80’s thru the 90’s…nobody knew what or why. And here we are now. Total insanity.

[jon]

My son was having trouble breathing last month so we took him to the ER. His 02 numbers were low so they wanted to admit him but that hospital did not have a pediatric ward so they made us take an ambulance (we were not allowed to drive him ourselves, we asked) to another hospital nearby. Both hospitals gave us separate ER bills, the pediatric ward gave us another bill, and even though both hospitals were in network the ambulance service was not and we got a separate $2, 000 bill for the 3-mile ride we were forced to take. All total our costs were around $15, 000. After fighting with the insurance and hospitals, we were able to reduce it to just under $2, 000 out of pocket.

I'm fortunate enough to be able to afford this but the system is so GD broken that I'm considering moving to Europe.

[daniellozobia]

I paid approximately $500 for a similar treatment in Portugal at a private hospital. This was with Allianz insurance. I was still within my deductible, so the $500 covered the entire bill.

What you are describing would simply be considered criminal in any other developed country, I am pretty sure.

[gugy]

Similar happened to me. I went to ER for three stitches and had insurance and end up paying $2k because one of the doctors wasn’t in the “group”. They offered the service for $600 if I paid cash on the spot without using my insurance.
It’s a grift to F… us.
I absolutely hate this system.

[jeanettenaumiec]

As the Taiwanese minister of health said in the Frontline episode titled Sick Around The World, The US doesn’t have a healthcare system they have a healthcare market. I say it’s a shell game along with big pharma and insurance companies it’s all about the profit even if the facility labels itself non-profit.

[Kelly_Ben]

I got the exact same bill, $5, 900, for 5 stitches in my thumb. After decent insurance, I paid $1, 500 out of pocket!! After many, MANY calls to the hospital asking for an itemized bill, they admitted that the bulk of the bill was their flat rate for a "level 2 visit." $8 for pharmacy, $400 for the ER room use (all of 45 minutes), under $2k for the Dr... and THOUSANDS as a flat fee, straight up profit. Because I'd used insurance, they were unwilling to negotiate. I raised such a ruckus, I got a check back from the corporation that had bought the hospital... for $60. We ALL need to start demanding itemized bills and asking questions...

[rdyer]

One reason we have this system in the US is because our politicians have their own different system. The same is true for Social Security. If they had the same systems we have, and experienced the same problems we do, they'd have more incentive to fix things. Unfortunately, this is another reason to be healthy: to avoid having to use our broken systems.

[CJ-qqgs]

Thank you, Doc. I hope this gets millions of views. Last year I was in the hospital for three days. They put me in the ICU, did every imaginable test, only to settle on myocarditis as an assumed cause of my prolonged high fever. Ultimately they just kept me under observation, and gave me fluids. The bill came about a month later… $50, 000. I was shocked. I thought the only option I had was to claim bankruptcy, or spend the majority of the rest of my life under crushing debt.. I don’t make much and I have a wife with stage four cancer with her own mounting medical costs. But thankfully… mercifully, I’m a veteran and eventually I was able to get the VA to cover the costs of my stay in the hospital. It’s terrifying to suddenly be saddled with an insane amount of debt you had not planned for, and I feel the pain of all those who are not as fortunate as I to be relieved of that debt. It’s got to change.

[ChrisGrande]

Great points. Cost disclosure and negotiation are key. When my son was a baby we were traveling and did his 3 month checkup on the road. I asked the office what was the cash cost of a visit. They told me $109 at the time, and it would be $330 if we used insurance. It is a total game. And the fact that politicians never discuss it tells you how corrupt (or thoughtless) they are. Disclosing costs would put a serious overall dent into costs.

[alfiegrace]

I am an American living in Germany. Wound up spending a total of 12 days in the hospital (ER, ICU, nephrology ward, kidney biopsy) and everything has cost less than $11, 000. Imagine how expensive that would have been in the US. The US system is broken beyond belief.