Why health care in the US can be very expensive?

In the tapestry of American life, the strand of health care costs weaves a complex and often costly pattern. A mere consultation within the hushed confines of a doctor’s sanctuary can command a sum that would make Gatsby’s pocket watch pause – hundreds of dollars for a slice of time, and a sojourn in a hospital bed for a trilogy of days can spiral to a small fortune, with the final figure as enigmatic as the melodies of a jazz age night.

Few among us have the coffers to face such fiscal tempests unaided, for sickness comes as unbidden – and unpredictable – as guests to one of Jay Gatsby’s grand soirées. In this realm of uncertainty, health insurance emerges as the great mitigator, turning the roaring torrents of potential costs into manageable streams.

It operates on a principle as old as the republic itself: a collective buffer against individual calamity. You, the consumer, enter into a covenant with the insurer, placing your premiums upon the altar of mutual protection. These premiums meld with those of others, a congregation of the hopeful, all casting their lot in against the fickle fates of health.

This grand gamble is orchestrated by the insurance titans, who, like the eyes of Dr. T.J. Eckleburg, watch over the balance of risk with a dispassionate gaze. Their ledgers are filled with the calculations of chance, ensuring the pool of premiums remains ample to sustain the flow of medical necessity.

And within this great American narrative of health and assurance, one finds a labyrinthine array of plans, a veritable smorgasbord of policies, each with its own rules and rituals as varied as the parties of West Egg – complex, confounding, yet a necessary shield against the vicissitudes of our mortal coil.

Where can you get health insurance today?

In the ever-shifting landscape of health care, reminiscent of the old Louisville in Daisy’s youth, insurance providers are the gatekeepers to the garden of medical resources. They, like the social elite of East and West Egg, determine with whom one may associate within the realm of care. The providers are a varied lot, an ensemble of physicians, sanctuaries of healing, alchemists in laboratories, apothecaries, and more.

As Gatsby’s parties were exclusive, so too are the networks of these insurance coteries. They enter into pacts with a coterie of providers who agree to extend their services at rates that whisper of hidden speakeasies – more favorable, more discreet. Enrollees are thus ushered through a preferential portal, where the cost of their care is softened by the gentle hand of agreed value.

To step outside this gilded network is to wander into the valley of ashes without a guide. Should an enrollee seek care from a provider who has not been welcomed into the fold, the insurance barons may tighten their coffers, dispensing only a pittance, or nothing at all, leaving the seeker to face the formidable costs as Gatsby faced the unattainable green light – alone and from a distance.

This principle holds a particular poignancy for those not native to the local Stanford precincts. Imagine, if you will, you are tethered to your parents’ plan, a plan whose network is rooted in the soil of your hometown. Here, in the Stanford realm, you may find the gates to care closed or only opened at a steep price. The gulf between in-network and out-of-network can yawn as wide as the chasm between old money and new, and it behooves the prudent to navigate these waters with caution, lest they find themselves financially adrift, far from the warm shores of home.

What does the plan cover?

In the landscape of American health care, a fresh gale has swept through under the banner of reform, much like the winds of change that stirred the leaves at Gatsby’s opulent mansion. The Affordable Care Act, a tome of promise and protection, has ushered in an era of standardization – the jazz age of insurance benefits, if you will. In the times before this act, the offerings of insurance plans varied as widely as the fortunes of the characters that danced through Fitzgerald’s pages.

Some plans, capricious as Daisy’s affections, might have included the coverage of prescriptions, while others, as cold and removed as Tom Buchanan’s heart, did not. Now, by the decree of this reform, a constellation of “essential health benefits” illuminates the health care firmament:

 1. Emergency services, a beacon in the tumultuous night.

 2. Hospitalization, an anchor in the storm of sickness.

 3. Laboratory tests, the scrutinizing eyes of T.J. Eckleburg, seeking out truth.

 4. Maternity and newborn care, the nurturing of life’s tender beginnings.

 5. Mental health and substance-abuse treatment, a hand extended to those lost in their own personal East Egg.

 6. Outpatient care, as vital and varied as the guests at Gatsby’s gatherings.

 7. Pediatric services, including dental and vision care, to tend to the smallest attendees of life’s party.

 8. Prescription drugs, the potions to quell the unforeseen tempests of health.

 9. Preventive services, akin to Gatsby’s own vigilance, and management of chronic diseases.

10. Rehabilitation services, the pathway back to the green light of wellness.

For those students hailing from shores beyond the expansive American ones, adrift in the possibilities of coverage from non-U.S. insurers, the question “What does the plan cover?” becomes as crucial as the whisperings of old secrets in West Egg. It is a question that must be posed, to unearth the extent to which their coverage will dance to the American tune or if it will leave them wallflowers at the edge of the grand ballroom of U.S. health care.

How much will medical insurance cost? 

The enigma of insurance coverage and its costs unfolds much like the plot of a novel set in the Roaring Twenties, filled with the opulence and hidden expenditures of Gatsby’s grand estate. We commenced our journey with the clarity of the premium – a straightforward expense, as clear as the light at the end of Daisy’s dock. This is the price of admission to the grand party of health care coverage.

Alas, this is but the first act in an elaborate play of financial commitment. When the time comes to partake in the health care system’s offerings, additional costs emerge from the shadows – deductibles, coinsurance, and copays, the co-conspirators of the insurance world. These are akin to the subtle, hidden glances in a crowded room, representing the portion of the bill that slips quietly from your pocket as you partake in the services rendered.

Imagine, if you will, a scale of choices: On one side, pay more now – higher premiums up front – and when the moment comes to seek care, the toll is lighter, a mere pittance in comparison. On the other, pay less initially, and like the surprise of an unexpected guest, you will be greeted with a heftier price at the time of service.

For our scholars, the quandary is as delicate as choosing between the allure of a moonlit soirée or the comfort of a quiet evening at home: to dispense more of one’s treasure now, or to brace for a future withdrawal. Our counsel leans towards the former; we advocate a larger contribution in the upfront premium to alleviate the financial burdens at the time of service. This philosophy is underpinned by a desire to remove any barricades that may stand between our students and the care they might require – a copay too steep may deter them from entering the doors of medical attention when their need is great.

In our eyes, we must not have the pursuit of health deterred by the specter of cost, just as Gatsby would not allow the whispers of East Egg to silence his grand dreams. The accessibility of care is paramount, and thus we encourage our students to err on the side of caution, to invest early in their health, so that when the time comes, the path to medical assistance is as clear and untroubled as the waters of West Egg.

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