Healthcare expenditure in America comes to 3 trillion dollars annually, about twice as much as most other western nations, including Australia. Photo / 123RF
When Molly Holzschlag was finally diagnosed with aplastic anaemia in December 2014, she was relieved that three decades of misdiagnosis were over - until she discovered the cost of her treatment.
The rare blood disease leaves the 54-year-old from Las Vegas suffering fatigue, tremors, and a depressed immune system that sees her highly susceptible to other illnesses. Even though she had recently acquired health insurance after years of being denied access due to having a pre-existing condition, it did not cover much of the cost of her care.
"One of my cocktails was a three month treatment program that I had to pay for in advance," she says. "It cost over $3,000 per day for 90 days' care."
"I paid $90,000 of my own money, which was my retirement savings. I had to pay it in full even though I was insured, so I had to crowdfund the rest."
It's difficult for Australians, with universal access to Medicare, to understand the magnitude of the cost of health treatment in the United States. For many Americans, even simple trips to the GP can cost $50 with insurance. For those without insurance, it can cost hundreds, and care is frequently forgone because it is simply too expensive.
Despite Holzschlag's successful career as a pioneering internet developer, including authoring over 35 books and making a number of media lists of the most influential women in technology, illness has cost her everything.
"I can't even estimate exactly what I've spent since getting sick," she says, "but it has resulted in loss of home, employment and has left me with about USD$250,000 in unpaid medical debt at this point in time, with no recourse to reduce it."
A key election promise of President Donald Trump was to "repeal and replace" the Affordable Care Act, better known as 'ObamaCare', the program which provided millions more Americans like Holzschlag with access health insurance.
But ObamaCare is also running into problems, with patients faced with high out of pocket costs, and many insurers pulling out of the market.
The President caused a stir last month prior to launching his American Health Care Act, with some commentators saying he clearly didn't understand the system when he claimed "nobody knew that health care could be so complicated."
Last Friday, the American Health Care Act bill was pulled before it was presented to the House, as Trump didn't have the votes to get it passed. That's despite Republicans controlling the House and the Senate.
After pulling his proposed Act, he told media "the best thing politically is to let Obamacare explode."
Healthcare expenditure in America comes to 3 trillion dollars annually, around 18 percent of the country's gross domestic product - about twice as much as most other western nations, including Australia. It is estimated that between $100-$150 billion of health care debt each year is placed with debt collectors.
"In the United States, you're only one illness or accident away from financial ruin," said Craig Antico, co-founded of the charity RIP Medical Debt.
Five years ago, they took an idea that sprung from the Occupy Wall Street movement to help everyday Americans by buying their debt from collection agencies.
"So far we've been able to clear about $25 million for about 16,000 people, but we're now scaling up our business, because there's so many groups of doctors, nurses, and family donors who want to help," he says. Their charity has plans to buy another $4 billion of medical debt, which is expected to aid around 300,000 Americans.
"It's estimated that 15 million people per year wipe out their complete savings because of medical debt," Antico says. "And debt collection has a long tail, with people often chased for 5 to 10 years for payment."
Those in the industry like Antico have long known how complicated health has become in the country. "There's something wrong - for all that expenditure, we don't even have better health outcomes," he notes.
Molly Holzschlag, who is beginning to look to alternative therapies after her experience with the health system, also now intends to make use of the legal requirement for emergency rooms to treat patients whether they have health insurance or not.
"The Republicans' healthcare plans make no sense," she said. "There's nothing there, they have absolutely no policy. Do you see them doing anything to take care of the middle class or the poor?"
Indeed, the non-partisan Congressional Budget Office has estimated that 24 million people will lose their coverage in the next ten years if the American Health Care Act is enacted in its current form - which will place significant stress on emergency services.
The ongoing debate about healthcare is also likely to cause both the President and the Republicans in congress further political pain, with a recent Fox News poll showing that only 35 percent of Americans approve of how Trump dealt with healthcare thus far, while a 2016 Gallup poll found 58 percent of Americans would favour a federally-funded system over the current patchwork of private and state care.
"Health in America is a pay to play system," Holzschlag says. "It's despicable to me that I can't afford the care I need."