I fully agree that we need to fix health care for the uninsured and underinsured in the United States.
However, do you ever wonder why so many Americans aren’t voting for socialized healthcare? In reality, most of us aren’t at risk of going bankrupt from a health care emergency. Again, I fully agree that too many people are at risk of going bankrupt from a healthcare emergency, but it’s not the norm for the average American like you might read online.
The United States does actually have government health care programs for low income and disable people (Medicaid, covers approximately 23% of the US population) and for elderly (Medicare, covers people 65 and over). We also have government subsidies for lower income people (up to 400% of the federal poverty level) who need to buy their own health care plans through the marketplace.
Again, it’s not perfect and I agree that improvements are necessary, but the reality of the situation is a bit different than many of the reductionist comments you read online.
When you’re earning 2x or even 3x as much as European counterparts (using my real-world experience managing international remote teams), paying the health insurance premiums doesn’t feel like as much of an inconvenience. In my case, my employer pays my premiums and my out of pocket maximum spending is capped at $1000 per year, worst case.
>The United States does actually have government health care programs for low income and disable people (Medicare, covers approximately 23% of the US population) and for elderly (Medicaid, covers people 65 and over). We also have government subsidies for lower income people (up to 400% of the federal poverty level) who need to buy their own health care plans through the marketplace.
Another way of putting your point is that 91% of Americans have medical insurance, whether through their employers, or government programs like Medicare/Medicaid. That's compared to 95-97% in other developed countries because there are always some people who fall through cracks, like (say) a Canadian who doesn't get a new provincial health care card after moving, or a German who neglects to buy into a new sickness fund after changing careers. The only such systems with actual 100% (or as close to it as possible) coverage is something like the UK NHS, which does not have a requirement to show a membership card (because, well, there isn't one) to receive treatment.
PS - Obamacare did not greatly expand coverage. 85% of Americans had medical insurance pre-Obamacare.
>Again, it’s not perfect and I agree that improvements are necessary, but the reality of the situation is a bit different than many of the reductionist comments you read online.
Indeed. There are things I'd certainly improve about the US system—decoupling primary healthcare coverage from employment, for one—but the way people online lie^H^H^Hexaggerate it's not surprising that so many non-Americans believe that every American is one hangnail away from bankruptcy.
Speaking of which, another common lie^H^H^Hmisrepresentation about Americans and health care: Only 4% of US bankruptcies are because of medical bills (https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...). A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.
>In reality, most of us aren’t at risk of going bankrupt from a health care emergency. Again, I fully agree that too many people are at risk of going bankrupt from a healthcare emergency, but it’s not the norm for the average American like you might read online.
In reality, every single person is at risk for a medical situation that will bankrupt you.
Ever drive? You're at risk for getting into a car accident that could lead to thousands or hundreds of thousands of medical costs.
One of the biggest lies of the american health care system is that your risks of medical costs is solely connected to your health.
You can be the healthiest person in the world, and a drunk driver can still lay your ass out. And that is being truly the healthiest person. Many people only seem like they're perfectly healthy, because diseases like heart disease and cancer can be lurking without symptoms for long periods of time.
The biggest cause of bankruptcy in the US is medical costs. STILL. The idea that most people are at risk of going bankrupt from a health care emergency is just false.
> The United States does actually have government health care programs for low income and disable people (Medicaid, covers approximately 23% of the US population) and for elderly (Medicare, covers people 65 and over).
That's wrong.
Medicaid covers the poor, Medicare covers the aged, blind, and disabled. (You can be both and be covered by both—and by either or both plus private insurance in some cases—which is a contribution to high healthcare administrative costs because of coordination of benefits.)
TL;dr 41% can cover a $1k emergency with savings. Others would get in debt. Sure, there are some ways for the very low end to get help. But that still leaves a massive number of people exposed.
> my out of pocket maximum spending is capped at $1000 per year, worst case.
Is that for any medical help from any source, or does that involve the in-network / out-of-network provider billing dance?
That was an informal poll performed by a personal finance website. It’s not a scientific study.
Furthermore, read the actual question they asked. They didn’t ask if people could pay the expense from savings. They asked how people would pay the expense.
The options include things like “reduce spending in other areas” aren’t mutually exclusive with being able to draw down on savings accounts. Many people prefer to reserve their savings for retirement unless necessary.
I'm not sure that really changes the overall picture. https://www.federalreserve.gov/newsevents/pressreleases/othe... gives 39% of people who would either go into debt, sell something, or couldn't cover an emergency $400. Even if the number is skewed a lot (say it's 20%), it's still a massive amount of people.
Your 20-30% claim is still way too high for even the median wages, ignoring typical SWE comp. it’s not clear where you got your numbers, but they’re not supported by the data.
The median US wages are covered by the subsidies above. Again, I want to emphasize that I support health care reform to improve coverage at the lower wages, but I’m trying to explain the discrepancy between the dire picture painted online and the seemingly irrational voting patterns of most Americans. The idea that you can move to a median European country and come out ahead financially due to government healthcare doesn’t really add up.
I wasn't the grandfather poster you're responding to. But I'll give you my perspective as a Brit. It seems to me a conflation of two separate things. The pro-business environment over the pond allows a lucky minority to capitalise and have a higher standard of living than most places in the world. That is a plus for people who can make it in the U.S. for sure. Glossing over the unlucky majority for the sake of the argument; this state of affairs doesn't seem entirely dependent on the lack of a national healthcare system. It just so happens that a slice of those lucky few don't want to lose their various golden geese, so they have been campaigning to keep the status quo.
Socialised healthcare is cheaper but my understanding. You could have your cake and eat it. I'm open to reading data pointing to the contrary.
It is true but it proves nothing. US has ridiculously inflated health care prices. According to this article https://www.bbc.com/news/world-us-canada-47491964 monthly cost of diabetics treatment in 2016 was $19 in Italy and $360 in the US. So US is spending here over 20 times more for the same treatment.
They charged $2,835 a day for the ventilator. Seriously? You may buy brand new ventilator for 29,000 PLN in Poland which is around $7500, hospital usage certified ‘PHILIPS RESPIRONICS TRILOGY 100’. You may rent brand new top model of Lamborghini in Los Angeles for around $2500 a day. In Europe they won’t even charge for the ventilator. The room, which costs on that bill $9,736 a day should be already equipped in everything what’s necessary to support life. If the room price doesn’t cover the equipment, does it mean it’s just 9k for the bed a day?
While there are definitely some horror stories about this in the US, it is a lot less common than people think. It turns out only about 4% of bankruptcies for adults are due to a hospitalization[0]. So you're much more likely to go bankrupt for other reasons.
That's not what the study is saying. They're not disputing the fact that bankruptcies are largely caused by healthcare-related costs. What this study says is that being admitted to a hospital only has a 4% chance of causing a bankruptcy.
The other thing I'd like to point out is that their sample set is entirely from California which is materially different from many other states in the US, so it's possible the 4% rate varies state-to-state.
>A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work.
(My emphasis.) In other words, people going bankrupt because health problems = lack of work = lack of income. That does not contradict the fact that only 4% of US bankruptcies are because of medical bills (https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0... that is, bills for health care treatment exceeding available income.
Your article goes on to quote a study author who carefully elides the difference between the two. Oh, by the way, he is a prominent proponent of Medicare for All! Imagine that.
Probably a lot? But it's honestly kind of hard to say and I have seen very conflicting data (such as the 4% vs 60% discrepancy in what percentage of bankruptcies are caused by medical bills). I do agree healthcare in the US is thoroughly terrible, even if for no other reason than exactly this uncertainty. If you go to the hospital or have some type of procedure done, you could be out a few hundred dollars or a few tens of thousands or even hundreds of thousands of dollars and there's really no way to know before you go in.
And my anecdotal experience only muddies my understanding even more. Things have always worked out pretty well for me. Even the time I got a $45,000 bill because the surgeon was covered by my insurance but the anesthesiologist was not, somehow in the end after a few phone calls to the billing department my portion was lowered to just an extra $400 on top of the expected copay. I have no clue how any of it works, but these insane numbers seem to often just go away as mysteriously as they appeared. I don't personally know anyone who has actually had to pay the absurd amounts of money that get quoted, it's like it's all some kind of fake money. (I do realize that I am probably in a very privileged bubble, most people I know are at least not uninsured for instance).
However, do you ever wonder why so many Americans aren’t voting for socialized healthcare? In reality, most of us aren’t at risk of going bankrupt from a health care emergency. Again, I fully agree that too many people are at risk of going bankrupt from a healthcare emergency, but it’s not the norm for the average American like you might read online.
The United States does actually have government health care programs for low income and disable people (Medicaid, covers approximately 23% of the US population) and for elderly (Medicare, covers people 65 and over). We also have government subsidies for lower income people (up to 400% of the federal poverty level) who need to buy their own health care plans through the marketplace.
Again, it’s not perfect and I agree that improvements are necessary, but the reality of the situation is a bit different than many of the reductionist comments you read online.
When you’re earning 2x or even 3x as much as European counterparts (using my real-world experience managing international remote teams), paying the health insurance premiums doesn’t feel like as much of an inconvenience. In my case, my employer pays my premiums and my out of pocket maximum spending is capped at $1000 per year, worst case.