[psd1]

Is medical bankruptcy common in Switzerland?

600chf sounds like passable value for money, as long as you get excellent care and as long as that's all you pay.

But my concern is always what happens to the poor. Yeah, yeah, the Swiss are rich - but not literally every Swiss, I presume.

[TMWNN]

>Is medical bankruptcy common in Switzerland?

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 any country.

[psd1]

I was asking about Switzerland, since you brought it up. It's a fascinating place, I'm keen to hear your observations.

Don't conflate bankruptcies. _Purely financial_ bankruptcy is recoverable, given good health and time. (Not to trivialise it.) But, for a peasant with terminal cancer: _medical_ bankruptcy generally means a miserable and undignified death. There's worse pain than pain, you know?

So, while I have to respect the dispassionate argument that "not _that_ many people die in a ditch", I reply that my £200 buys me not just passable healthcare but also some pride in my nation finding some fucking compassion.

That moral point is also an economic point, but I'm not ready to articulate it concisely. Let me say simply that a nation needs to find character on the way up and then again on the way back down, and America is currently fumbling for the second step. A nation is founded on its citizens. The cost of a zeitgeist of rage and distrust is, eventually, everything. What price empire?

[TMWNN]

> I was asking about Switzerland, since you brought it up

sarah_eu brought up Switzerland, in comparison to the UK NHS. I don't know what percentage of Swiss bankruptcies are because of medical bills, but can cite the statistic for the US (which of course is the main topic here). Also, as I alluded to, "[insert large percentage here] of bankruptcies in the US are because of medical bills" is a common incorrect trope in/about the US, which I wanted to fend off before it came up yet again.

>But, for a peasant with terminal cancer: _medical_ bankruptcy generally means a miserable and undignified death.

Obamacare mandated that the 15%[1] of Americans pre-Obamacare that did not have health insurance get it or pay a penalty. The figure is 8% now.

And before you say "Well, that's not 100%", while the penalty for Obamacare noncompliance is not high enough, 92% of Americans having health insurance is not very far from the 95-97% elsewhere, and some large share of the 8% is from illegal aliens who are ineligible or avoid signing up for government health insurance. In every country there are people who fall between the cracks, whether a German who neglects to sign up for a new sickness fund after changing jobs, or a Canadian who neglects to sign up for a new provincial health care card after moving. The only way to get actual 100% coverage is to use the UK NHS model of having no membership card at all.

[1] Yes, 85% of Americans before Obamacare had health insurance. How many of you non-Americans (heck, many Americans) thought that "0% of Americans have healthcare" before or after Obamacare? It's OK; you're not alone in believing everything you read on Reddit.

[davidgay]

> Only 4% of US bankruptcies are because of medical bills

I'm going to hazard a semi-informed guess (I grew up in Switzerland, live in the US), that 0% of Swiss bankruptcies are because of medicals bills.

And https://www.amjmed.com/article/S0002-93430900525-7/fulltext disagrees with you, claiming 62% of US bankruptcies are due to medical bills... (other links report somewhat lower figures, e.g., https://www.self.inc/info/medical-debt-bankruptcies-statisti..., but definitely nothing as low as 4%).

[TMWNN]

The Washington Post piece I linked to (Permanent URL: <http://web.archive.org/web/20180326154159/https://www.washin...> discusses the Himmelstein article the letter you cited cites. As arpinum said, Himmelstein et al. conflate any debt that includes medical bills at time of bankruptcy with "medical bills caused bankruptcy".

[arpinum]

Neither of your links are primary source data and give an incorrect interpretation. If you follow the links to the primary data you will find the phrasing changes from "medical problems contributed to..." in the source to "health care expenses were the most common cause of bankruptcy" in your citation.

The numbers you cite are the percent of bankruptcies that include medical debt. The data doesn't say the medical debt caused the bankruptcy, or that this debt type was the largest percentage of debt. People declaring bankruptcy typically have many types of debt as they generally fall behind on all their bills.

[pierrebeaucamp]

> But my concern is always what happens to the poor.

There are subsidies available to low-income households. I'm unsure about the specifics as subsidies differ from one canton to another and usually depend on your income and family status.

[BlueTemplar]

Yes, exactly, while the average USian might still keep up with the rising costs of healthcare,

(and in fact being the cause of rising costs because that is where they are going to spend their disposable income),

the median USian will not.

Partially this also comes from statistical effects that aren't scale-invariant :

Countries with more people are more rich (including per capita).

Countries that are richer are more inequal.

Countries with more people are more inequal.