QA问答：在美国，如果有人付不起医药费怎么办？
What happens to someone in America if they cant afford their medical bills?
译文简介
网友：这并不是说你无力支付医疗保险！1996年，我44岁的妻子被诊断出患有结肠癌。她不吸烟，有着非常健康的生活方式，当时她突然在浴缸里滑倒后，去医院给自己的背部照了x光，因为她认为自己的背部受伤了。在她接受放射治疗期间，她的医疗保险到期了。当我试图付钱的时候，她取消了她的保险，称这是一种既存状况.....
正文翻译
What happens to someone in America if they cant afford their medical bills?
在美国，如果有人付不起医药费怎么办？
评论翻译
很赞 ( 1 )
收藏
it is not about not being able to afford medical insurance! In 1996 my 44 year old wife was diagnosed with Colon cancer. 44 years old. non smoker a very healthy lifestyle and suddenly after a slip in the bathtub she had an xray of her back because she thought she has hurt it. While she was being treated with radiation her insurance premium came due. When I trie to pay it the cancelled her policy calling it a preexisting condition. At the time I was the CEO of a highly respected children’s mental health hospital. We had the very best insurance money could buy then. her treatment was topped and she died a few weeks later. I lost my wonderful wife, our home, cars and everything else I had worked for my entire professional life. We had just finished personally building the home we expected to retire in on a beautiful island in Washington State. I wound up moving to an apartment.
这并不是说你无力支付医疗保险！1996年，我44岁的妻子被诊断出患有结肠癌。她不吸烟，有着非常健康的生活方式，当时她突然在浴缸里滑倒后，去医院给自己的背部照了x光，因为她认为自己的背部受伤了。在她接受放射治疗期间，她的医疗保险到期了。当我试图付钱的时候，她取消了她的保险，称这是一种既存状况。当时我是一家备受尊敬的儿童精神健康医院的首席执行官。那时候我们有最好的保险，她接受了最高级的治疗，几周后她就去世了。我失去了我可爱的妻子、我们的家、汽车和我整个职业生涯为之奋斗的一切。我们自己刚在华盛顿州一个美丽的小岛上建好了房子，打算退休后住进去，我最后搬去了一间公寓。
在一年的时间里，我试图理清生活的一切，我决定做一件我从未做过的事情，这也令我自己感到震惊。我应征了一则从西雅图到墨西哥的帆船船员招聘广告。船长找我是因为我在墨西哥工作过，也学会了流利的西班牙语。我卖掉了我所有的东西，然后我们离开了这里。我们去了墨西哥，然后去了巴拿马，我正要回家的时候，我问他在干什么。他说“我要去西部，想去吗”，我答应了他，几个月后，我航行到了加拉帕戈斯群岛、马克萨斯岛、塔希提岛和其他岛屿，最后来到了新西兰的纳尔逊岛。那些地方看起来都很漂亮，那里的人也都很好。我决定留下来看看后面会发生什么，我找到了一份教师助理的工作，最后成为了这个国家资历最老的特许医院的院长，现在我退休了。我曾有过重大的健康问题，比如因感染疟疾而进行了肝脏移植，膝关节置换术等等。我的妻子是一个典型的美国人，她认为美国是世界上最好的地方。不幸的是，她大错特错了。如果我能说服她搬来这里的话，那她可能还活着。我永远不会原谅美国的，我也不会再去那里了，也不会在那里花一块钱。
I would like someone from the Right who screams “Socialism” (meaning “Communism”) when asked why they are against any form of a national health care system defend your experience as being appropriate. I thank you for sharing. It is these real life experiences that will hopefully one day bring Light to the hearts and minds of the Right.
当被问及为什么他们反对任何形式的国家医疗保健系统时，我希望有一个右翼人士能大声疾呼“社会主义”（意思是“共产主义”）来捍卫你的经历，这是最合适的。谢谢你的分享，正是这些真实的生活经历，希望这些经历有一天能给右派的心灵和思想带来光明。
The NHS is NOT socialist it was the brainchild of none other than Winston Churchill, it is like Police, Government, armed forces and the like a Socialised system paid for by taxes for the benefit of all.
PS Nye Bevan was the health minister in Churchill’s wartime government, and fought him tooth and nail to stop Churchill bringing the NHS into existence during WW2.
国民健康保险制度不是社会主义制度，它是温斯顿·丘吉尔的构想，它就像警察、政府、武装部队，就像一个由税收支付的社会系统，造福于所有人。
Nye Bevan是丘吉尔战时政府的卫生部长，并竭尽全力阻止丘吉尔在二战期间建立国民健康保险制度。
Sorry for the loss of your wife, my Late Fiance Marichu died Of Brain Cancer 2 yrs ago she was only 41 yrs old I loved her Sooo much. Before the brain cancer she had breast cancer 4 yrs ago I emptied out Most of my 401 k retirement account to pay for her Surgery and her Chemo treatments And blood transfusions for almost 1 yr. She got Healthy again but then got this Horrible brain cancer, the US govt penalized me thousands of dollars for early withdrawal even though it's medical emergency this is a DISGRACE period. Many millions of Americans even with Health insurance if U get serious disease can Wipe U out Financially. That's why we need Universal healthcare for all Middle class and Poor Americans just like in Canada, Australia and European countries even third world Country Cuba has Universal healthcare for all its Citizens. Bernie Sanders is the main politician to support this. The problem in USA is many politicians in both political parties are Corrupt Elitists who are all in Bed with the big Insurance and Pharmaceutical companies.
很抱歉你失去了妻子，我已故的未婚妻Marichu两年前死于脑癌，她只有41岁，我非常非常爱她。在她患脑癌的四年前她得了乳腺癌，我花光了我401k，我退休金账户的大部分钱来支付她将近一年的手术，化疗和输血费用。她恢复了健康，但后来得了可怕的脑癌，美国政府因为我提前取款而罚我几千美元，即使这些钱用于医疗紧急情况。那个时候，数以百万的美国人，即使有医疗保险，如果你得了很严重的疾病，在经济上也会让你一贫如洗。这就是为什么我们需要为所有中产阶级和穷人提供全民医保，就像加拿大、澳大利亚和欧洲国家，甚至第三世界国家古巴为所有公民提供全民医保一样。伯尼·桑德斯是支持这一点的主要政客。美国的问题是，两党许多政客都是腐败精英，与大型保险公司和制药公司沆瀣一气。
You are exactly correct. New Zealand is like Canada. if she had been here she may still be alive. here everyone is treated equal. I moved over 20 yrs ago and passed all my medical and immigration stuff to become a citizen. 8 yrs after being here I fet unusually sick and went to see my doc. I was told I had 8 months to live! I was the director of th oldest hospital in the country. I was told I needed a liver transplant! Whaat?! Turns out when I was 17 I left America to both avoid going to Vitenam and to continue my studies. I moved to Mexico. My minor was Anthropology and I was stomping through the Yucatan jungle in sandals and tee shirts. Dumb youth. I contracted malaria. Not a fun time but got over it. That was 1967. It took from then to 2007 for it to show up. I never knew it damaged livers. Anyway I received a new liver, my wife was flown to Auckland where I was in hospital and put up in a 4 star hotel for 3 months to be with me. All our airfares were paid for. No expense was on us except food. I have had a knee replacement and that was free as well. Don’t tell me docs are inferior with universal healthcare. It is a two pill cure. it is free here but 5 yrs ago the same medication in the US was $80,000 per pill!
你说的对，新西兰和加拿大很像。如果她当时生活在这里，她可能还活着。在这里每个人都被平等对待。20多年前我搬了家，通过了所有的医疗和移民手续，成为了美国公民。在这里生活了8年后，我感到身体有点不舒服，我去看我的医生。我被告知我只有8个月的生命！ 我是这个国家最古老的医院的院长。我被告知我需要肝脏移植！什么？我17岁的时候离开了美国，既不想去越南，又想继续我的学业。我搬到了墨西哥，我的辅修课程是人类学，当时我穿着凉鞋和T恤在尤卡坦丛林中漫步。当时年轻的我太愚蠢了，我染上了疟疾。虽然过程很不开心，但还是挺过来了。那是1967年。从那时到2007年，身体才出现了问题。我从来不知道这种疟疾会损害肝脏。不管怎样，我接受了一个新的肝脏，我的妻子跟我一起飞到奥克兰，我在那里住院，并在一家四星级酒店住了3个月，我的妻子和我在一起。我们所有的飞机票都付了。除了吃的，我们没有任何开销。我做过膝关节置换手术，而且是免费的。别跟我说医生在全民医保下是低人一等的。这是一种两颗药丸的治疗方法。这里是免费的，但5年前同样的药物在美国是8万美元一粒！
Thank you very Much for your comments Robert, I'm glad your Happy in New Zealand. Yes seems like U have Very good Universal healthcare in New Zealand as well just like your neighbor country Australia. I actually on my Late father's side have distant relatives from Queensland Australia but I had never met them. His side of family is mostly from Sicily and Austria but some migrated to Australia.Yes in the USA they brainwash everyone that if we have Universal healthcare their tax rates will go up to 70 percent and the medical care would be inferior.Thats what happens when Bernie Sanders campaigns for Universal healthcare in USA. Maybe someday we will have in USA, you take care always God bless.
非常感谢你的评论，罗伯特，我很高兴你在新西兰过得很开心。是的，看起来你在新西兰也有非常好的全民医保，就像你的邻国澳大利亚一样。事实上，我已故父亲那边有来自澳大利亚昆士兰的远亲，但我从未见过他们。他的家人主要来自西西里岛和奥地利，但也有一些移民到了澳大利亚。是的，在美国，他们给每个人洗脑，说如果我们有全民医保，他们的税率会上升到70%，医疗保健会更差。这就是伯尼·桑德斯在美国推广全民医保时发生的事。也许有一天我们会在美国，愿上帝保佑你，永远保重。
Unfortunately most people in the US believe to the point of being brainwashed that the “Land of the Free” is better than anywhere else in the world. Look at the way trump has consistently repeated his “false truths” (called lies in most parts of the world), and US people just suck it up. Even people elected to uphold the integrity and honour of their Government can’t bring themselves to call him on his dishonesty. And the people just lie down and take it.
The wonder and awe that the rest of the world once had for everything USA is quickly turning to mockery and derision
不幸的是，大多数美国人认为“自由之国”比世界上其他任何地方都好，这种观点已经深入他们的大脑。看看特朗普一直在重复他的“虚假事实”（在世界大部分地区被称为谎言），而美国人只是接受他的这种谎言。即使是那些被选来维护政府诚信和荣誉的人，也无法对他的不诚实行为提出谴责。而人们只是躺下接受。
世界上其他国家曾经对美国所拥有的一切都感到惊奇和敬畏，而现在这种惊奇和敬畏正迅速变成嘲笑
My dad had colon cancer a few years back, he and his brother were diagnosed at the same sort of time. It was such a miserable time, I can’t imagine losing your home and property too. It seems like a lottery in America, healthcare is great so long as you don’t need it. If you do you could lose everything. My dad and his brother are both clear now, my dad only went to to doctor with indigestion and they diagnosed him within a few days and had him in for surgery a week or two later, he was so frail when he came home, he looked his age for the first time in his life snd he had a hole right through him where they removed his bowel etc . He wouldn’t have accepted any treatment if it would have cost us our Home, I know what he’s lik, but it didn’t cost us a penny, except for new Pjs and slippers and stuff to take in to hospital.
USA is so cruel to her own people. And the worst thing is the people fight for the system they have, so scared of being perceived as socialist, but why are police and fire depts not considered socialist then? I’m so sorry you had the experience you did, but I really admire your bravery and perseverance in trying something completely new - more than once, and thriving.
我的父亲几年前得了结肠癌，他和他的兄弟在同一时间被诊断出患有结肠癌。那是多么悲惨的一段时间，我无法想象失去自己的房子和财产。在美国，这就像买彩票一样，只要你不需要，医疗保健就很好。但如果你需要医疗保健，你可能会失去一切。我爸爸和他弟弟现在都没事了，我爸爸只是因为消化不良去看医生，医生几天内就诊断出他了，一两周后让他做手术，他回家的时候很虚弱，这是他有生以来第一次看起来符合他的年龄，在他身上有一个洞，他们在那里切除了他的肠子。我知道他是一个什么样的人，他是不会接受任何治疗的，即使这会让我们失去我们的家，但我们没有花一分钱，除了睡衣、拖鞋和一些送到医院的东西。
美国对自己的人民太残忍了，最糟糕的是，人们为他们现有的制度而战，他们害怕被视为社会主义者，但是为什么警察和消防部门不被认为是社会主义的呢？我很抱歉你有这样的经历，但我真的很钦佩你尝试全新事物的勇气和毅力——不止一次的尝试，而且很成功。
A lot of people just die.
A lot more suffer with treatable conditions for years with a low quality of life. This limits their ability to contribute to society through work.
Some will try to pay out of pocket and then experience crippling debt for the rest of their life.
All in all? The system sucks for most people who can't afford care and are not quite destitute enough to be in Medicaid.
很多人就这么死了。
更多的人患有可治疗的疾病，但他们的生活质量很低。这限制了他们通过工作为社会做贡献的能力。
有些人会试图自掏腰包，然后在他们的余生中经历沉重的债务。
总而言之呢？这个系统对大多数无法负担医疗费用的人来说很糟糕，而且他们还没有穷到可以享受医疗补助的地步。
You die. But before you too do you lose your home, your children’s college fund, everything your family has earned and worked for for 20 years. And you leave your spouse and children a legacy of crushing debt that will ruin their lives.
你死了，但你失去了你的房子，失去了孩子的大学费用，以及你的家庭工作了20年赚来的一切。
你给你的配偶和孩子留下了一笔沉重的债务，这会毁了他们的生活。
I have a friend who had breast cancer. The cost of radiation treatment, chemotherapy, and eventual mastectomy were so obscenely high that she could not have paid it off in 3 lifetimes. She had to file bankruptcy. A young couple were trying to cope with the expense of the birth of their first child when they get pregnant again. After the birth of their 2nd child, they had to forego buying a starter home and instead filed for bankruptcy. The for-profit American healthcare industry is harming people whether they have critical illness or just ordinary medical expenditures like childbirth. And of course, prescxtion drugs are so high that many people are rationing their medication, such as insulin, thereby endangering their own lives.
Filing bankruptcy appears to be the only answer for many. The only way to get out of this bottomless pit is to get government-negotiated healthcare and pharmaceuticals for everyone. It is already being done with Medicare and VA. It is just a matter of making Medicare for All a reality through Congressional legislation.
我有个朋友得了乳腺癌。放疗、化疗和最终乳房切除手术的费用高得令人发指，她不可能用三辈子的时间来偿还这些钱。
她不得不申请破产。一对年轻夫妇再次怀孕时，正努力解决生第一个孩子的费用问题。在他们的第二个孩子出生后，他们不得不放弃购买第一套住房，而是申请了破产。营利性的美国医疗保健行业正在伤害人们，无论他们是患有重病还是只是普通的医疗支出，如分娩。当然，处方药的价格非常高，以至于许多人都在定量配给他们的药物，比如胰岛素，以至于可能危及他们自己的生命。
对许多人来说，申请破产似乎是唯一的结果。摆脱这个无底洞的唯一方法是让政府为每个人提供医疗保健和药品。联邦医疗保险和退伍军人管理局已经这样做了。这只是一个通过国会立法使全民医疗保险成为现实的问题。
It varies significantly depending on where you live.
In most Democratic and swing voting states, Medicaid has been expanded to include the overwhelming majority of people who make 150% of the Federal poverty line and lower.
Basically all of the states that are blue on this map have viable public healthcare systems for the poor.
Above the 150% poverty number, ACA subsidies tend to come into play. If you are at the lower end these ACA subsidies can pay for up to 50% of your premium.
Even still, in many rural areas insurance plans are too costly. As an example, my self-employed housemate gets a subsidy which makes his otherwise $450 /month premium closer to $280 /month in the Pittsburgh region. His friend who is also self-employed and makes roughly the same income, pays $600 /month after subsidies for a similar plan in Weirton, WV (30 miles away from Pittsburgh.)
So in many areas people make too much to qualify for Medicaid, but even with ACA subsidies, can only barely or can't afford the premiums.
Nevertheless, the poorest do qualify for Medicaid in the expanded states, and many people are happy with their ACA subsidized plans.
Ultimately roughly 30% of the population is uninsured or underinsured and they span the whole range of the bottom 50% of the population by income.
这取决于你住在哪里。
在大多数支持民主党和摇摆不定的州里，医疗补助计划已经扩大到包括绝大多数达到联邦贫困线150%或更低的人。
基本上所有地图上蓝色的州都有针对穷人的可行的公共医疗系统。
超过150%的贫困人口，ACA的补贴就开始发挥作用了。如果你是在贫困人口的末端，这些ACA补贴可以支付高达50%的保费。
即便如此，在许多农村地区，保险计划仍然过于昂贵。举个例子，我的室友得到的补贴使他在匹兹堡地区每月450美元的保险费接近280美元。他的朋友也是个体经营，收入和他差不多，他在WV的韦尔顿(距匹兹堡30英里)做了一个类似的计划，扣除补贴后每月支付600美元。
所以在很多领域，人们的收入太高，无法获得医疗补助，但即使有ACA的补贴，他们也只能勉强或无力支付保费。
然而，在扩大的州中，最穷的人确实有资格获得医疗补助，许多人对他们的ACA补贴计划感到满意。
最终约有30%的人口没有保险或没有足够的保险，它们涵盖了收入最低的50%人口的全部范围。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
You die, it is as simple as that. Most go into bankruptcy to get healthcare which is not the thing to do, but strangely they love their dear departed. CHRISTIAN CONSERVATIVES cannot understand this, it boggles their minds that someone would value the life of a loved one over the ALMIGHTY DOLLAR! They are appalled by this and strangely say they are PRO LIFE! They will tell you how they find life sacred as long as someone else if footing the bill!
你会死的，就这么简单。大多数人破产是为了获得医疗保健，这不是一件应该做的事，但奇怪的是，他们爱着死去的亲人。基督教保守派无法理解这一点，他们的想法难以置信，有人会把所爱之人的生命看得比万能的美元还重要！他们对此感到震惊，并奇怪地说他们是支持生命的！他们会告诉你，他们觉得生命是多么神圣，只要有人为他们买单！
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
To be honest, it varies wildly. It all depends on who you are, where you are, and what is wrong with you. White with credit, chances are good. Anything else, you might as well go home and die.
Need to rename “Healthcare” to “Dollar care” because in the grand scheme of things, that is all the hospital is interested in. Don't get me wrong, the doctors and nurses definitely care and sympathize with you. But the hospital still rules.
老实说，差别很大。这完全取决于你是谁，你在哪里，你有什么问题。有了信用，机会很大。否则，你还不如回家等死。需要将“医疗保健”改名为“美元保健”，因为从大局来看，美元才是医院感兴趣的。别误会我的意思，医生和护士们都很关心和同情你。但医院仍然是有规矩的
I assume this means after treatment and when the bill comes?
They don’t pay. After a few “overdue notices” it will go to a collection agency.
Collection agency will call several times a week..More letters..They might try to call some of your close relatives to see if they know where you are. Meanwhile, your credit score will tank. If you had plans to take out loans (car, mortgage, small business) you will get denied or a very high interest rate.
There are some options that can be done from here:
-You can initiate contact with the collection agency and negoiate a settlement. If it’s under $5k, they’ll prob make a settlement offer (like if you owe $700, they’ll settle for a one time payment of $450). If it’s higher than that, they’ll push hard for to get payment plan going.
-Declare bankruptcy.
-Continue to be delinquent, your credit will continue to drop, but after 3 to 5 years (again, pending how much you owe) it might be forgiven.
我想这意味着在治疗之后和账单来的时候？
他们不付钱，几次“逾期通知”后，就会送到催收公司。
讨债公司每周会给你打几次电话，发更多的信件，他们可能会给你的亲戚打电话，看他们是否知道你在哪里。与此同时，你的信用评分会下降。如果你计划贷款（汽车，抵押贷款，小型企业），你会被拒绝或需要非常高的利率。
这里有一些可以做的选择：
你可以主动联系讨债公司，协商解决。如果低于5000美元，他们可能会提出和解方案（比如，如果你欠700美元，他们会一次性支付450美元）。如果高于这个数字，他们就会努力推动支付计划的实施
宣告破产
继续拖欠，你的信用就会继续下降，但是3到5年之后（同样是在你欠多少钱的时候），你可能会被原谅。
There were two times in my adult life when I went without healthcare insurance. One was when I changed jobs, the other was between when I retired and Medicare kicked in. During both periods if I had had a serious accident or a serious illness, I would have been wiped out financially, so the whole time I was in that state I was on tenterhooks, as it were. Just crosses my fingers and hoped for good luck.
Worst case scenario one can get some care through emergency or charity services but it isn’t much.
我成年后有两次没有医疗保险。一个是在我换工作的时候，另一个是在我退休和医疗保险开始生效之间。在这两个时期，如果我发生了严重的事故或严重的疾病，我就会在经济上一贫如洗，所以我一直处于这种状态，就好像是坐立不安一样，就祈祷好运吧。
I hate to be vague but much depends on how much you owe and to whom. Some providers will work with you, allowing you to pay what you can afford per month. If you fall behind they'll turn your account over to collections. If its a large sum that's owed I've known providers turn an account over after 90 days. Some people accept charitable donations. There was a collection taken for one of the staff at a local filling station to help with her cancer related bills. This us a common occurrence. So you see there us no fixed rule, and it us true that huge medical bills on top of a mortgage payment, car note etc is enough for people to file for bankruptcy.
我不想含糊其辞，但这很大程度上取决于你欠谁多少钱。一些供应商会与你合作，让你每月支付你所能负担的费用。如果你逾期不还，他们就会把你的帐交给托收公司。如果你欠了一大笔钱，据我所知，供应商在90天之后就会把你的账户交出来。有些人接受慈善捐赠。有人为当地加油站的一名工作人员募捐，以帮助她支付与癌症有关的账单。这是常有的事，所以你看，我们没有固定的规则，我们确实有巨额的医疗费用，加上抵押贷款，汽车票据等足以让人们申请破产。
I had medical bills I definitely couldn't afford to pay. Even with a decent paying job today I still can't afford it. I didn't pay them, and it went against my credit worthiness which if you have a better credit rating you can get things, home, car,etc., at a cheaper rate. So not paying your medical bills hurts that the most. But in laymans terms nothing happens except for that. Depending on how serious the care you are needing. I suppose you could be sued. And if that were the case we wouldn't have the judicial arena to handle all the cases. The population who can't pay their medical bills is astronomical.
我有我绝对付不起的医药费。即使现在我有了一份体面的工作，我还是负担不起。我没有还钱，这违背了我的信用等级，如果你的信用等级更高，你就能买到东西，房子，汽车等等。而且是以更便宜的价格。所以不付医药费是最不利的。但在外行看来，除此之外什么也不会发生。这取决于你需要的护理有多严重。我想如果你不付医药费你会被起诉的。如果是这样的话，我们就没有司法机构来处理所有的案件了，付不起医药费的人数是个天文数字。