[codingdave]

I'm not defending it. I'm correcting your misinformation. You are claiming that ACA plans do not cover childbirth. They do. You are claiming that this event alone costs 40K, which is not accurate. It hits your out of pocket max, exactly as designed.

It sounds like you have never looked at an ACA silver plan, which is the lower deductible/out of pocket max option. I also have a family of 5, and have a $1800 per year out of pocket max from an ACA plan. You would still have the same level of premiums as you do now for silver plans, but you would save 13K a year. You are picking bad plans, dude.

Our system has problems, but when you make enough to not be subsidized, yet still pick a crappy 40K per year plan, that is beyond the systemic problems. It is a bad choice. There are insurance consultants who work with people, especially high income people, to find good plans for their family. You should be calling them.

[Aaronontheweb]

Dude, you don't even have your own facts straight and you are embarrassing yourself. It's clear you have no experience, don't understand your own sources you provided, or any clue how child birth actually works from a medical billing standpoint.

Edit: what do I have to gain from spreading "misinformation?" I just want better / more options?

[tptacek]

I don't know what you have to gain from it, but you're wrong. 42 U.S. Code § 18022, (b)(1)(D). ACA plans are required to cover childbirth.

[Aaronontheweb]

That's not what the link the OP included said and not what I said either, but I concede your point - that's my fault for checking individual health care marketplaces (like eHealthInsurance and Aetna direct) or not looking closely enough on healthcare.gov.

Looking through some plans now, but TBH these are genuinely not much of an improvement in the cost department and a massive downgrade in the provider selection department. Hence my whole section on trade-offs.

[tptacek]

The logic you're using about out-of-pocket costs versus your deductible appear also not to be valid, and are causing you to misstate your out-of-pocket liability by a factor of roughly 4x.

[Aaronontheweb]

I can assure you they are, if anything, understated - as I am not including the expenses my health insurance will not cover. So no, you are fully in the wrong there. What do I have to do to prove it? Show you itemized receipts?

Moreover, what are you even trying to accomplish by asking for this? Please provide me with a forthright defense of the modern U.S. health insurance markets and why it makes sense for me to have to pay this much to keep our population above replacement level.

[tptacek]

Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.

As for your second question, one easy response is that prospective parents in other health care systems aren't paying less (with everything factored in) but rather differently: that people making your $119k "true" poverty rate in Europe tend to be taxed at their top marginal rate, which is substantially higher than ours (in fact, in a lot of places in Europe, a Chicago Public School teacher would also be paying the top marginal rate).

A thing worth pointing out is that while the system we have is especially punishing on the uninsured, it's actually not that bad a deal for the insured, demographically/actuarially speaking. That's because being insured definitionally puts you in the cohort that excludes Medicaid-eligible poor/working class people and fixed-income seniors. If you move the typical household from that cohort to the UK, they're likely to be worse off. In surveys, insured families tend to be satisfied with their insurance, which is why taking existing health insurance off the table is such a third rail in American health policy.

Anyways, unless you personally are responsible for keeping our population above replacement level (which sounds exhausting), your numbers just aren't probative for the cost of bringing new citizens online. Other numbers might be!