[bongobingo]

If you’re not American, it’s difficult to understand.

However, insurance is an absolute scam in the US. You pay hundreds of dollars per month for the privilege of having to pay thousands of dollars before your insurance will start paying. For many families the monthly premiums could run over a thousand dollars, and the deductible could be $15,000.

…or you could get some cheap catastrophic insurance, and pay cash for everything else. The cash price is generally less than half of the insurance price.

Many people have done the math and concluded that they don’t need insurance.

[enkid]

I am American, and I understand how health insurance works, and the fact that people are put into a position where it doesn't make sense to buy health insurance is the problem, not that individuals make that choice.

[pjc50]

I can understand not wanting to deal with insurers, especially American ones, but I can't understand accepting that that means either no healthcare or potentially catastrophic losses.

You can never know that you're not going to need healthcare.

[bongobingo]

Well you used to be able to buy decent catastrophic insurance to protect you from unlimited losses. ACA effectively killed that type of insurance.

[rovr138]

That’s also a VERY high premium AND deductible.

Not saying it’s not out there, but they both are high.

[ceejayoz]

Here in upstate New York, my insurer's Bronze plans run about $1100/month for a family (https://myportal.dfs.ny.gov/documents/538523/9578747/Excellu...).

That gets you a $10k family deductible, and a $13,100 max out-of-pocket. https://www.nyhealthinsurer.com/insurance/pdfs/plans/1319

I pay $2,200 a month for a family Platinum plan, in order to get $0 deductible and $4k/year max OOP.

The true cost of healthcare is masked for most, via their employer coverage - quite a few people seem to genuinely believe theirs costs just $20/month because that's the portion they directly pay. It's quite the scam on the American public.

[vidarh]

For comparison, UK NHS budget is ~$4500 per year per capita. No deductables.

About ~10% have private insurance in addition to e.g. avoid queues etc. for non-critical care since NHS triages by clinical need. Typical price for private cover is usually ~$50-$200/month per person.

The true scam on the American public is that the way your healthcare is regulated means US taxpayers pay about the same UK taxpayers do towards public healthcare, but Medicare and Medicaid are unable to provide universal care for that money because they're artificially prevented from e.g. negotiating best possible prices for services and drugs, and the rest of the regulatory regime completes a system that is basically welfare for the healthcare and insurance industry.

So you pay roughly that per capita and then your private insurance on top.

Germany got it's first universal public healthcare insurance system in the 1880's under Bismarck because Bismarck was worried about outright revolution, because the notion of being without healthcare was one of the things driving rapidly rising resentment. Most of the rest of the developed world followed over the course of decades. That Americans are still putting up with this kind of massive wealth transfer to corporations by politicians today speaks to a disturbing level of subservience to corporate power.

[bongobingo]

It’s more complicated than what you’re saying. The health care industry in the US is almost 15% of the GDP and employs about 10% of the workers. It is difficult to quickly fix this system without catastrophic economic consequences. Unfortunately, our political leaders are unable or unwilling to plan more than 2-4 years out.

To fix this system we would need a 10-15 year transition period, and it’s virtually impossible to make that happen. No single President could oversee the process from beginning to end, and Congress could change party control 6-8 times.

The reason we haven’t fixed this problem isn’t because we love corporations, but because no single political party is willing to commit suicide.

The Democrats talk a big game, but it’s pretty much all talk. Bernie Sanders home state of Vermont tried to implement a single payer system, and failed spectacularly. Vermont is a tiny state. Imagine the disaster it will be trying to pull the rug out from under the healthcare economy for the entire United States.

https://www.vox.com/2014/12/22/7427117/single-payer-vermont-...

[rovr138]

I know it gets high. I pay $700 something for my wife and I (the vast majority of that is including my wife).

My main issue, and why I commented, it’s because they put a high monthly premium and a high deductible and usually when one’s goes up, the other one goes down.

It’s framed as trying to explain it for someone outside of the US and I think it makes a poor job because it doesn’t explain that they picked máximums and didn’t explain how they usually relate and interact with each other.

> For many families the monthly premiums could run over a thousand dollars, and the deductible could be $15,000

[ceejayoz]

I'm pointing out that this:

> That’s also a VERY high premium AND deductible.

isn't true, at least in my area.

[bongobingo]

The average premium for a family is over $1,000. The average family deductible is around $7,000. The numbers I quoted are high overall, but people absolutely pay those amounts. This topic of conversation is edge cases, anyway. The average person paying average costs wouldn’t likely be interested in going cash for healthcare.