[marcinzm]

The issue is that insurance companies don't always pay out as they have incentive to find ways to avoid paying. Then you're on the hook. If I remember, deductibles for example don't fully cover many hospital stays so you get hit with out of pocket costs. Those have a maximum cap but I'm sure there's some caveats if you end up in a hospital that's not in network for example. This is what people talk about when they say they went bankrupt despite having insurance.

edit: For example checking the Maryland ACA page is showing maximum out of pocket costs of $7k/person for most plans and up to $17k/family for some. When you make $24k/year that will wipe out your savings for years.

[marcinzm]

To expand on this. The average healthcare cost in the US is $7k/year/person for the working age population. Children are an additional $3k/child/year. Since insurance companies are private businesses they will be paid $7k/year/person on average. No loopholes, no ifs, no buts. As such, no matter what your plan says or what the tradeoffs are (deductible, monthly, etc.), on average you will be paying them $7k/year/person. If you're paying for it yourself then that price will be paid by you. Now, you can avoid medical treatments to lower that price but I hope it's obvious why that's not a good social solution.

That price may come out of monthly premiums, deductibles, out of pockets or copays but it will be paid out on average.

In a universal healthcare system the government can use progressive taxes to subsidize this cost for the less well off. In a private system that isn't the case.

So if you make $24k/year that comes out to 30% of your income. Assuming you get the average standard of medical care in the US. You may get lucky and avoid this but lotteries aren't good ways to live life.

edit: Please note I'm talking about the working age population. I don't think the elderly make sense in this discussion given that there's government health coverage for them.

[rayiner]

> The average healthcare cost in the US is $7k/year/person for the working age population.... In a universal healthcare system the government can use progressive taxes to subsidize this cost for the less well off.

Except we don't have a fully-private system. We have Medicaid, which covers the working-age poor, and also people with disabilities which is a very high-cost group. Then we have Medicare taking the high-cost elderly population. And then we have ACA potentially subsidizing much of the rest.

> So if you make $24k/year that comes out to 30% of your income.

In Maryland, a low-deductible Kaiser ACA Gold plan for a 36-year old making $24,000 per year costs $3,864/year. But the government pays $2,533 of that, leaving you to pay $1,380 + out of pocket costs.

Out of pocket expenditures in the U.S. add up to about $1,100/year on average: https://www.healthsystemtracker.org/indicator/access-afforda.... But note that other countries have out-of-pocket costs too. Even in France, where point-of-use costs are very low, it's still $463/year.

Your typical person making $24,000 per year is going to be young, and not rack up $1,380 in out of pocket costs each year. But adding that in, you're looking at 10.3%.

[dragonwriter]

> The average healthcare cost in the US is $7k/year/person for the working age population. Children are an additional $3k/child/year.

Actual US healthcare spending in 2019 was $11,582/person.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

[tptacek]

That's not the average cost per person; it's simply the total amount of health care spending, in all categories, in the US divided by its population.

[dragonwriter]

Which is also the arithmetic mean cost per person, by definition. Which average did you have in mind?

The median might arguably be a more useful average here, but I doubt the data necessary to even identify the median individual cost are kept.

[tptacek]

The person you responded to was talking about direct-to-consumer costs; you switched figures while suggesting that their number was erroneously low. You were wrong.