There is rationed care here in the US, but it's based purely on price.
My insurance is not accepted by one of the major hospitals here, and none of the clinics affiliated with that hospital take it either. That already cuts my options for healthcare in this town in half, even though I have insurance.
The other major hospital has three options for when I'm sick.
1. I can make an appointment with my family doctor, which usually requires a week's wait because appointments tend to be booked. If I'm checking on something that isn't urgent, this is what I do. It's the cheapest too; my copay is $35, which is totally reasonable. If he has to refer my to a specialist, however, I'm looking at a month or two wait, and they have to be one of my PPOs for my insurance to even consider it.
2. I can go to an Urgent Care center, which costs more than my family doctor but they'll see me today. My copay for this is more than the actual visit in many cases, so I end up paying this out of pocket. ($65 for a visit, my copay is $75, so unless I've got diagnostic testing, I'm screwed.)
3. Emergency room. $250 copay. I avoid this and have only gone once since I've lived here, when I had an abcessed tooth that had developed a boil. I'll save this for catastropic coverage in case I'm about to die or something.
Because these options are limited, I usually ignore my insurance and go with option 4: Public health department. It's cheap, it's same day walk in appointments, and I get better care there than I do at the freaking doctor's office. I'll be going there next Tuesday for my annual violation and for a refill of pills, and I can expect to pay under $100 for the whole kit and caboodle. A comparable visit at the private doctor would set me back well over $200, only a portion of which insurance would cover since my insurance doesn't do lab work.
Edited, Jun 12th 2009 12:22pm by catwho
