Hallo everybody.
I’m from Europe and although I’ve travelled quite a lot this side of the pond, I’ve never been to the USA, a country I’ve come to love for all it’s given to the world.
There’s one thing I’m particularly concerned about though and it’s the US Health System. Since it has a bad reputation here in Europe I would like to know from US residents how/if this reputation is justified.
I will be visiting Chicago for a week, and I read that I should buy health insurance. But I don't know if I should bother with it. I don't plan on getting sick, and if something does happen to me, I already know that hospital emergency rooms must take care of me. I don't want to pay for healthcare in America (why should I? I don't have to pay for healthcare in my country, so why should I have to pay for it in the U.S.?) I doubt they will send hospital bills to a foreigner in another country.
Any thoughts?
Thanks a lot for your help.

I am from New Zealand and if you don't take out health insurance when you go and visit the US you are a FOOL. Hospital emergency rooms don't actually have to treat you, and I know for a fact that New Zealanders who haven't had health insurance in the US have had to pay bills in excess of the $ 500,000 range not just for the hospital care but to get repatriated back to their own country.

$500,000 for being repatriated? Did they ship those people back with a Space Shuttle?

Anyway I find this very irritating and certainly something that doesn’t encourage tourism - in the middle of a world recession.
I thank you for your help, nelsonian, but I confess I still have my doubts. I think I’ll go without insurance, out of principle, and see if they let me die on the street (fingers crosses) should something happen to me.

Why should other countries be required to pay for tourist health care? I mean travel insurance is cheap compared to the cost of a vacation why shouldn't someone have some personal responsibility?...As far as your comment on medical repatriation do you have any idea what kind of care your getting? Your getting a private jet with just you and a medical staff on it. Someone has to pay for the pilots,Fuel not to mention the medical staff and the equipment. As a footnote all ER's have to treat you but you'll be getting a nasty bill in the mail if you don't have insurance..

No one ever plans on becoming ill on a trip.

But let us assume you have something painful and/or serious (kidney stone or auto accident or food poisoning) that strikes the young and healthy as often as the old and decrepit and you go to an emergency room.

Before you are treated (if you are conscious) you will have to sign a document accepting financial responsibility for your treatment. This is court-enforceable. A typical emergency room visit will cost you a thousand or so dollars, and twice as much again if they do a CAT scan. If they do emergency surgery, you may well be looking at $50,000 or more.

If you are not insured, you will be expected to put it on your credit card before you leave. No insurance? You will have to work out a payment plan with the hospital, again, a legally binding document. Even with insurance, you will have to pay the deductible on your credit card before you leave.

The other option for treatment is what we call a "Doc in a Box", a stand-alone medical clinic, often in a shopping center. In my experience as a traveler, these charge typically $125-$200 for a simple visit with a physician and perhaps some emergency treatment for an illness, a cut requiring tetanus injection or the like. If you have a major condition, you will be off to the emergency room -- after having your credit card charged for the full cost of your initial clinic treatment.

At this point, the charges are between you and your credit card company. The alternative is travel insurance.

The other alternative is to go bare and hope you will be treated as a charity case, not perhaps the most moral position for someone who has the funds to travel to the US, but even charity cases have to sign payment plans.

They will come after the money. Remember my bit about "court enforceable" above? Well, should you not pay, they will get a judgement against you and come after you for the money. Just look on Metafilter to see what has happened to people who have tried to skip out on US debts. Most US court judgements are enforceable in most West European countries (I don't know about others) and part of the interminable US Immigration waits occur because people are being checked against databases of criminal and civil charges. Remember also that the passenger lists are transmitted ahead of the plane, and when you land, they already know who will be asked to step into this office, please.

So if you think you might want to visit the US again or work for a company that might send you here, please don't do this out of principle. It is an almost incredibly dumb idea. If you have the money to travel, you have the money to buy travel insurance.

As an RN in the US, I agree with much of what Ackislander stated in above post. A point important enough to restate is that hospital ERs do not HAVE to treat you unless it is a life-threatening situation - they likely will, but not for any follow-up care.

And to disagree with a premise from your post about how you do not pay for healthcare in your own country - everyone pays for health care one way or another - thru taxes, insurance or paying privately. In the US taxes only pay for health care of the poor (and a portion of care for the elderly). Your taxes in your country pay for your health care.

Dadelus -

Healthcare in the US is not free. It's true that in am emergency you can go to an ER and will not be turned away IF it is an emergency. But if you just have some sort of routine problm they may refuse to treat you without charge. In any csse you will be billed and expected to pay. This care is NOT free. And yes, they will do everything they can to collect what you owe.

(I've been billed for a hospital test 6 years later. At the time of the test I had insurance, the hospital accepted the insurance assignment and I didn't owe anything. But, through an oversight they had never billed the insurance company, found out 5 years later and the insurance company refused to pay - typically you have to present bills within 12 months. the hospital then began to try to collect from me, going so far as to send it to a collection agency. Luckily I kept all the paperwork and contacted the hospital's atorneys and was able to prove that the hospital had accepted assignment - and not billed me for 5 years. This let me off the hook - without the back up I might have had to pay the money - $1200.)

Also, if you are given any prescriptions you will have to pay for that as well - and won;t get it without without paying the pharmacist.

Healthcare in the US is the best in the world - but not free. Visiting without a travel insurance policy including healthcare is foolhardy. It doesn;t matter if you don;t plan on getting sick. What if you do? What if you trip and sprain an ankle? What is you develop food poisoning? You don;t want to be out hundreds if not thousands of dollars. (And ERS do ask for you insurance card before they treat you - unless the situation is life-threatening - a shooting or a heart attack or similar.)

Under the OP's reasoning, because I don't pay high taxes in the U.S., I shouldn't pay the ridiculously high VAT in Europe and Canada.

Sorry -

I admit we travel without health insurance - since all we would need is the repatriation part - and that is EXTREMELY unlikely. But our US health insurance covers us around the world - we sign agreeing to pay, file as soon as we return home and receive payment that we have (just once) sent to the MD involved.

Our travel agent in Australia will not sell a ticket to the U.S. without travel health insurance.

American health charges are amongst the most expensive in the world ,and you are just plain crazy if you don't take out travel insurance - a minute part of overall travel costs.You simply cannot predict when you may need medical assistance.

Whilst travelling my husband had to seek medical treatment in Europe and I have had to do the same in the U.S. On both occasions it was not a choice and travel insurance readily paid all charges and all costs of medication (so expensive in the States I almost had a relapse!).

I've never bought travel insurance to go to Europe or the UK either because my current health policy covers me abroad for up to three months, but next spring I turn 65, and Medicare does not cover medical costs outside the country, including Canada and Mexico, so I have to make sure that my supplementary policies will.

@nytraveler
“Healthcare in the US is the best in the world
No it isn’t. At least not according to the World Health Organization.
http://www.nytimes.com/2007/08/12/opinion/12sun1.html
http://www.photius.com/rankings/healthranks.html
We rank at #2 while the US trails at 37th.

Also, I’ve seen on another thread about Italy where you wrote “tourism is THE largest industry in Italy”.
No, it isn’t.
As a matter of fact tourism accounts for just 2.1% of the GDP. The largest industry in Italy is the manufacturing sector.
http://epp.eurostat.ec.europa.eu/cac...-08-550-EN.PDF


Anyway I thank you all for your accurate (hopefully) info, even though I think you’re all being a little too alarmist. I will decide later if I’ll get the insurance and how much attention I should really focus on this topic that may not even affect me unless I fall ill.

Fyi, Dedalus appears to show many of the attibutes of a troll.

NYTraveler is referring to quality of healthcare...the article you linked to is talking about quality of healthcare as only one factor (which includes access to healthcare and cost of same). The US does rank #1 in quality of healthcare -- really, is there any question about that?

As for the actual cost, let me confirm what Ackislander has already said. My daughter tripped and fell down 3 steps on our side porch a year ago. Turns out she broke her ankle very very badly. She needed surgery. The bill for the hospital alone (not including the surgeon, the medical equipment we needed for home since she was off her feet for 8 solid weeks, etc.) was $55,000. She was in the hospital from Saturday morning (when we first went to the emergency room) until Monday at noon (surgery was Sunday). She theoretically could have gone home Sunday night, so maybe the cost would have been slightly less, but she had to stay for reasons that are specific to her. Anyway, $55,000 for the hospital alone.

Good luck to you if you want to take that chance.

"Fyi, Dedalus appears to show many of the attibutes of a troll."

A single post on Fodors, committed to stirring up disagreement. You think???

"really, is there any question about that?"

I'd have a question about that but I'm afraid I'd be labelled as a troll.
So I can't win, can I? It's either accept the supremacy of US healthcare as a given or end up being a troll.

Ok, this is a travel forum, so let's just leave it at that. A week passes very quickly and it's not my business after all.
Thanks everyone.

I only scanned the posts, but wanted to suggest that if you do go without insurance, many areas now have Urgent Care centers that can take care of small emergencies on a cash basis. These are usually less expensive than an ER visit. So, you might want to at least have one 'scoped out' just in case.

Of course, if it is a life threatening condition, head straight to a hospital ER.

Good health to you.

"It's either accept the supremacy of US healthcare as a given or end up being a troll."

The issue is a very interesting one and there are few in the U.S. who would suggest that U.S. healthcare is the best, in terms of cost or access. We do have cost and access issues.

In terms of your motives in posting this question, that's a totally different issue.

Dedalus - Your position makes no sense. In your country, your healthcare is funded by tax dollars and because of that, you think you should be entitled to use US tax dollars for healthcare in the US should you need it. Why should you be entitled to use US tax dollars for your healthcare? You haven't paid into our system. What principle says that it is ok to attempt to use services that you are not entitled to?

Most Americans don't even qualify for government health benefits - we buy our own health insurance policies. And when we travel, if our health insurance policies don't cover us abroad, we buy supplimental policies.

You say that the US government should cover healthcare costs for uninsured tourists to encourage tourism - the fact of the matter is that our tourist taxes are not high enough to fund something like that. It would be a money losing proposition.

Dedalus I actually agree with you that I think the price of health care in the US is ridiculously high, but I know that if I want to travel to the US it would be just crazy not to pay for the
$ 300NZ for full health insurance cover.

It may or may not be the best in the world, that's beside the point really. If you get sick or injured while you are in the US then it's the US hospitals that are going to treat you.