Family physician, author, blogger, speaker, physician leader.

Protect yourself from unnecessary stress and personal bankruptcy – welcome to the US health care system

As a fellow Canadian who has lived in the States since 1985 and in California since 1997, I felt compelled to write his blog post after watching a heart wrenching story / stream about a Canadian woman seeking medical care in Los Angeles who ended up spending 90 (!) hours at a mental health / urgent care facility for an involuntary psychiatric hold or a 5150.

via https://twitter.com/akaNemsko/status/1570561399126118405?s=20&t=9ou8IaIiH3WDgTVG2qdh9w

As the only doctor in my family, I know I’ve protected them more often than not from the dangers of the US health care system since 2000 (!), and I always want to help when I can for those who simply don’t know, are too busy, or just unaware. This is for you. Share widely. First off and stating the obvious:

It’s not you. It’s the US health care system.

The following recommendations are what I would give my family, friends, and my children if they were uninsured because of the type of work they did (creatives, influencers), inability to get coverage (work part-time or not with an employer who offers coverage) using my insider knowledge as a primary care doctor / family physician at Kaiser Permanente as well as chief clinical officer of direct to consumer digital health company Lemonaid Health (acquired by 23andMe in October 2021).

Get health insurance to protect yourself from personal bankruptcy

For decades, the LEADING cause of personal bankruptcy is unforeseen medical bills / health care costs. Unless you plan on living as a hermit and never moving anywhere, something will happen.

You roll an ankle going down the stairs. Now you are hobbling.

You get clipped by a car when running with your AirPod Pros.

You go to a party and get food poisoning and have to go to the ER because you are vomiting, lightheaded and can’t stand up.

You have an anxiety / panic attack and accidentally take too much of your anti-anxiety medicine thinking it will help and instead getting side effects and now you are scared and need a medical evaluation.

For decades, it’s well known that uninsured patients get charged the MOST! Don’t let this happen to you. Get health insurance, even if catastrophic coverage, it protects you against financial personal bankruptcy. Youth is an advantage as you are generally healthier than people who are older. Life happens though and insurance whether true health insurance (or at the very minimum catastrophic health insurance) allows you to bounce back financially… This isn’t Canada! (sorry!)

Catastrophic health insurance / short-term plans / medical indemnity plans – check out ehealthinsurance.com

Health insurance – better choice than above, but will be more expensive.

For Californians, check out Covered California – think Expedia / Hotels.com where you can select different health insurance options (Gold, Silver, or Bronze) which have to “compete” but have basic common sense standards to be covered as outlined by the Affordable Care Act (ACA) also known as Obamacare. (Before the ACA, health insurance plans had polices that they sold to women which did NOT cover pregnancy or delivery of the baby… sad, but true). Also before ACA, adult children were kicked off their parent’s health insurance somewhere between age 19 to 23 (allowed to stay on if they were college students for example). Since ACA, adult children are able to stay on their parent’s health insurance plan until age 26!

The differences between Gold, Silver, and Bronze is how high is your deductible and how does that relate to your monthly premium. Plan accordingly. High deductible and lower premium means you need to have some cash ready for any emergency department co-pays, office visit co-pays, etc. Remember goal here is to protect against personal bankruptcy. One ER visit can cost tens of thousands of dollars. Research shows that those with health insurance halved their risk of medical debt (16.2%) versus those who were uninsured (30.8%).

Out of all the California plans, I would always choose Kaiser Permanente because it is easiest to access and has a seamless experience (which is unusual in health care). In April 2011, I wrote about how Kaiser Permanente (KP) was integrated more like Apple and then can focus on you. Most recently thrilled to see that Fast Company in September 2022 awarded KP 2022 Design Company of the Year. My family and I still get care at KP as I used to work there and also served on the Board of Directors from 2005 to 2014.

No health insurance you want to wing it

Why, why, why? But if you choose this, I truly hope you are lucky and nothing bad happens. As a primary care doctor, I don’t want anything bad to happen but you are an adult and you get to choose. So you want care and don’t want to get gouged by the health care system which charges uninsured people MORE.

For doctor evaluation – telemedicine

Check out Sesame – which like Expedia / Hotels.com (see a theme here) – offers various doctors and providers via telehealth for affordable cash pay prices. Better than going to the emergency room or urgent care, unless you truly have to go. If not sure, worth it to check with a doctor on Sesame rather than wing it, checking with friends, social media (unless you have a following of doctors) or Google and a hope and prayer whatever issue, it will go away. Having a state of perpetual fear is not how I wish to live and unless you plan on going to medical school, check with a professional if you really aren’t sure.

For Prescription Medicines

If you need prescription medicine, check out GoodRx.com. Ask your doctor what medicine they are prescribing, what is the dosage (milligrams) and how many pills. GoodRx allows you to search by pharmacy for your zip code which pharmacy has the cheapest price for your medicine. You need to punch in the information and then show the coupon to the pharmacist to get the GoodRx price. If you don’t and you don’t have health insurance, you will get charged more!

Example is for a common antibiotic used to treat urinary tract infections (UTI). Pricing in Los Angeles ranges from less than $5 to over $20, a 4 X difference in price for the SAME medicine!

If you need URGENT CARE

and you need to see a doctor in person and it’s not a true medical emergency, then urgent care is an option. But how do you choose?

I’m a big fan of Solv which is like OpenTable except its for urgent care clinics and allows users the ability to book times to so you aren’t waiting or wondering.

Good luck!

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