8 ms·

You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed. In addition, the fact that's part

You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed. In addition, the fact that's part of every discussion gives a hint of how much of an issue this is.

seppin 9y ago
> You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed. you buy subsidized insurance. do Europeans really think the USA is just a free for all ?
- esolyt 9y ago
  They do because that's how most educated Americans describe their country to Europeans.
- oAlbe 9y ago
  There's a point below which you can't afford any kind of even subsidized insurance. Not if you want to keep paying rent, buy food, car insurance to keep going to work, phone bill, electric bill and so on. Whereas in the part of Europe where I live, the less you have the less healthcare costs you. EDIT: The less it costs for the same quality.
  - wil421 9y ago
    I'm not really sure where you get your information. Anyone can get Heath insurance from the healthcare.gov marketplace. Your salary requirements factor into the price. Someone making only 17k a year is capped at $54 a month premium. There are caps at certain salary intervals. > Whereas in the part of Europe where I live, the less you have the less healthcare costs you. 100% true for the US as well. Please don't listen to news or internet comments. Verify the facts!
    - unclepresent 9y ago
      If you are not getting subsidized because of income, you have to pay for everyone else who is subsidized. I was buying plans from health care exchange for 2 years and my last plan for two (parent and child) cost me 500$ per month with 6500 deductible per person - 13000$ total. So effectively I had only a catastrophic insurance but was forced to pay for some subsidized guys who had a platinum plan with no deductible for 54$ per month. Worst situation for people like me!
  - kobeya 9y ago
    Before that point you qualify for free insurance through one of many government welfare programs. Learn about the system before you criticize it.
    - dragonwriter 9y ago
      That's actually not true in any of the states that didn't sign on to the ACA Medicaid expansion, which, yes, was designed so that between exchange subsidies and Medicaid eligibility there would be affordable subsidized or government provided coverage across the whole spectrum where people didn't have employer coverage or the ability to afford unsubsidized coverage.
      - kobeya 9y ago
        It's also not true of extremely high cost of living areas such as NYC or the bay area where you're living beyond your means long before you qualify for government programs based on poverty levels that are calculated averaged across the nation. The system has warts. There are good reasons to criticize it. But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting.
        dragonwriter 9y ago
        > But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting. Well, except that it's exactly true that that’s why the “warts” that you acknowledge which do, in fact, deny swaths of the poor access to care are tolerated.
- SolaceQuantum 9y ago
  Subsidized insurance which still gives you costs for healthcare and sometimes doesn't cover certain tests or treatments that are considered not essential, such as birth control to treat polycystic ovaries or a blood test to diagnose functional sexual hormone levels(such a test would also detect polycystic ovaries, which untreated results in further health complications), More effective antibiotics for infection, multiple kinds of mental health medication, and dermatological medication. Not to mention confusing limitAtions of location of treatment due to network effects.
- Broken_Hippo 9y ago
  Yes, or worse. I'm American. I live in Norway. Most folks I talk to from other countries - not just Europe - find the American health care system to be cruel and too expensive for the common person. And by the way, I do not buy subsidized insurance. I pay my taxes, and I have health insurance. My taxes pay for health insurance. There is nothing else to pay to get that, other than a small fee for the doctor out of pocket up to a certain amount. No doctor, no medicine = no payment. Other than taxes, assuming I'm working and paying taxes.
  - e12e 9y ago
    Nit: "everyone" pays taxes - you get healthcare even if you don't pay any taxes (eg: college student without taxable income, unemployed not receiving benefits (yes, there's income tax on unemployment benefits)).
    - Broken_Hippo 9y ago
      That's a very small bit of the population, but you are right. Nearly everyone gets health care, minus some classes of immigrants. I knew there were taxes on unemployment benefits (and i'm not opposed to that). But even the folks not paying employment taxes generally pay tax through food, transportation, entertainment, and other things.
dogruck 9y ago
Strange how the US healthcare setup is largely unchanged over many years, yet the general perception is that it's suddenly total chaos. I'm not saying the status quo is best, but we didn't suddenly plunge into a crisis.
- jerf 9y ago
  Almost everyone is politically motivated in some way to slam the healthcare system; nobody is politically motivated to defend it. Personally I'd offer the somewhat-feeble defense that it isn't as bad as people say it is, but I'd stop far short of calling it good... because I've got my own political axes to grind too, even if they are nearly diametrically opposed to the local consensus. But it isn't actually true that the American health system requires you to sign into indentured servitude the moment you walk in the emergency room door, and injects you with strychnine and tosses you out the door if you can't pay enough to satisfy the bureaucracy this week. Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape. Doctors do not actually giggle with glee and make "chaching!" noises when giving you bad diagnoses.
  - chimeracoder 9y ago
    > Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape. Why would they? The US produces a surplus of blood and tissue, to the point that many other countries (particularly in Europe) have to purchase to from the US to address their own shortages.
- ashark 9y ago
  It's been incredibly bad for at least ~3 decades. A sick person with insurance without a dedicated advocate (relative or friend) watching out for them non-stop will likely end up having several care screw-ups occur to them, and with a bill ludicrously rather than just insanely large and probably a few things in collections (even if they can pay them) if said advocate doesn't spend a couple hundred hours fighting insurance and hospital billing and mailing regulators and wrestling a mountain of paperwork and bills. Watched this process with sick relatives in the 90s, and it was already fucked-up then. Gone through it with my wife's 3 pregnancies and a couple family illnesses in the last 5ish years. Same thing. It's a broken, evil system that ruthlessly exploits and crushes anyone without the time, wits, and wherewithal to fight it every step, and it has been for a long time. I think what changed is we have much better exposure to what it's like elsewhere, so more of us are aware that there is no reason whatsoever to keep hurting people this way.
drzaiusapelord 9y ago
Well, you can buy partly subsidized or receive fully subsidized healthcare (ACA/Medicaid). That's on top of programs like COBRA and in worst case scenarios welfare from the state, county, or federal levels. We also have CHIP on the federal level which is a separate program just for children, where the parents may have insurance but for some reason cannot insure their kids. That's on top of what the states themselves offer, but that's sort of rolled into the ACA nowadays, which makes more sense. We're at 8% uninsured, which is nothing to brag about, but its far from a free for all post-apocalypse where people keel over in their desks or in the unemployment line. Its also important to note that those numbers include illegals who can't or won't get insurance due to citizen status and 1/3rd to 2/3rd of that number actually qualify for various insurance programs, but for some reason aren't seeking it (aside from citizen status). We absolutely have a big problem with the rural poor and insurance, which is a hefty 14-20% of that demographic. I'm not sure what the fix here is especially considering rural states are heavily conservative and fight off ACA and Medicare/Medicaid expansion regularly.
- ChemicalWarfare 9y ago
  upvoted. as far as the rural areas vs ACA are concerned - before ACA a lumberjack/construction/handyman/hunting-fishing guide etc type dude could by themselves cheap health insurance that wouldn't break the bank off-season. now it's an ordeal.
  - drzaiusapelord 9y ago
    The problem there is that low rent health insurance didn't cover anything. You'd had catastrophic plans with $2,500+ deductibles and a cap at $25k. It didn't cover preventative maintenance, doctor visits, kids, drugs, etc. It only made sense in a "what if I injure myself at work, but not too seriously" kind of way. I imagine ACA mandated insurance is a net boon here even if the monthlies are more.
kobeya 9y ago
You walk into an emergency room and get treated without paying a cent.
- wil421 9y ago
  Seriously, if I believe what everyone comments on HN I would think hospitals are turning sick or injured people away.
  - kobeya 9y ago
    My mama taught me to not talk about things I don't know anything about. I wish more people listened to their mamas. To the curious Europeans out there, if you lose your job you can stay on your job's health plan for 18 months while you look for new work. If you're unemployed that long then you'd qualify for Medicaid after that, the government insurance program for the poor. If for whatever reason you really didn't have insurance you will nevertheless never be turned away from any hospital emergency room. This "die in he street because you have no insurance" is a myth and total hogwash.
    - pkaye 9y ago
      Make sure mama also told you these two things... Cobra insurance after losing your job requires you to pay the full premium which can be upwards of 10k per year. Also Medicaid has a very low asset threshold that you can still qualify unless you are pregnant, have young kids, disabled or elderly. ACA subsidy is the best shot for most in this situation but who knows how long till it is dismantled.
    - dkonofalski 9y ago
      It's not hogwash when actual, documented cases exist of people not going to the emergency room for fear of being crushed to death by the debt from an ER visit. And COBRA doesn't just give you free insurance for 18 months, you have to pay the full premium for it. If you're unemployed, how in the hell do you expect to pay the full premium as opposed to the premium that you were paying before that was subsidized by your employer? You've clearly never, ever been in a position where money was an issue for you. Especially not to the point where you felt your life was in danger because of it.

seppin 9y ago

> You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed. you buy subsidized insurance. do Europeans really think the USA is just a free for all ?

esolyt 9y ago
They do because that's how most educated Americans describe their country to Europeans.
oAlbe 9y ago
There's a point below which you can't afford any kind of even subsidized insurance. Not if you want to keep paying rent, buy food, car insurance to keep going to work, phone bill, electric bill and so on. Whereas in the part of Europe where I live, the less you have the less healthcare costs you. EDIT: The less it costs for the same quality.
- wil421 9y ago
  I'm not really sure where you get your information. Anyone can get Heath insurance from the healthcare.gov marketplace. Your salary requirements factor into the price. Someone making only 17k a year is capped at $54 a month premium. There are caps at certain salary intervals. > Whereas in the part of Europe where I live, the less you have the less healthcare costs you. 100% true for the US as well. Please don't listen to news or internet comments. Verify the facts!
  - unclepresent 9y ago
    If you are not getting subsidized because of income, you have to pay for everyone else who is subsidized. I was buying plans from health care exchange for 2 years and my last plan for two (parent and child) cost me 500$ per month with 6500 deductible per person - 13000$ total. So effectively I had only a catastrophic insurance but was forced to pay for some subsidized guys who had a platinum plan with no deductible for 54$ per month. Worst situation for people like me!
- kobeya 9y ago
  Before that point you qualify for free insurance through one of many government welfare programs. Learn about the system before you criticize it.
  - dragonwriter 9y ago
    That's actually not true in any of the states that didn't sign on to the ACA Medicaid expansion, which, yes, was designed so that between exchange subsidies and Medicaid eligibility there would be affordable subsidized or government provided coverage across the whole spectrum where people didn't have employer coverage or the ability to afford unsubsidized coverage.
    - kobeya 9y ago
      It's also not true of extremely high cost of living areas such as NYC or the bay area where you're living beyond your means long before you qualify for government programs based on poverty levels that are calculated averaged across the nation. The system has warts. There are good reasons to criticize it. But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting.
      - dragonwriter 9y ago
        > But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting. Well, except that it's exactly true that that’s why the “warts” that you acknowledge which do, in fact, deny swaths of the poor access to care are tolerated.
SolaceQuantum 9y ago
Subsidized insurance which still gives you costs for healthcare and sometimes doesn't cover certain tests or treatments that are considered not essential, such as birth control to treat polycystic ovaries or a blood test to diagnose functional sexual hormone levels(such a test would also detect polycystic ovaries, which untreated results in further health complications), More effective antibiotics for infection, multiple kinds of mental health medication, and dermatological medication. Not to mention confusing limitAtions of location of treatment due to network effects.
Broken_Hippo 9y ago
Yes, or worse. I'm American. I live in Norway. Most folks I talk to from other countries - not just Europe - find the American health care system to be cruel and too expensive for the common person. And by the way, I do not buy subsidized insurance. I pay my taxes, and I have health insurance. My taxes pay for health insurance. There is nothing else to pay to get that, other than a small fee for the doctor out of pocket up to a certain amount. No doctor, no medicine = no payment. Other than taxes, assuming I'm working and paying taxes.
- e12e 9y ago
  Nit: "everyone" pays taxes - you get healthcare even if you don't pay any taxes (eg: college student without taxable income, unemployed not receiving benefits (yes, there's income tax on unemployment benefits)).
  - Broken_Hippo 9y ago
    That's a very small bit of the population, but you are right. Nearly everyone gets health care, minus some classes of immigrants. I knew there were taxes on unemployment benefits (and i'm not opposed to that). But even the folks not paying employment taxes generally pay tax through food, transportation, entertainment, and other things.

dogruck 9y ago

Strange how the US healthcare setup is largely unchanged over many years, yet the general perception is that it's suddenly total chaos. I'm not saying the status quo is best, but we didn't suddenly plunge into a crisis.

jerf 9y ago
Almost everyone is politically motivated in some way to slam the healthcare system; nobody is politically motivated to defend it. Personally I'd offer the somewhat-feeble defense that it isn't as bad as people say it is, but I'd stop far short of calling it good... because I've got my own political axes to grind too, even if they are nearly diametrically opposed to the local consensus. But it isn't actually true that the American health system requires you to sign into indentured servitude the moment you walk in the emergency room door, and injects you with strychnine and tosses you out the door if you can't pay enough to satisfy the bureaucracy this week. Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape. Doctors do not actually giggle with glee and make "chaching!" noises when giving you bad diagnoses.
- chimeracoder 9y ago
  > Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape. Why would they? The US produces a surplus of blood and tissue, to the point that many other countries (particularly in Europe) have to purchase to from the US to address their own shortages.
ashark 9y ago
It's been incredibly bad for at least ~3 decades. A sick person with insurance without a dedicated advocate (relative or friend) watching out for them non-stop will likely end up having several care screw-ups occur to them, and with a bill ludicrously rather than just insanely large and probably a few things in collections (even if they can pay them) if said advocate doesn't spend a couple hundred hours fighting insurance and hospital billing and mailing regulators and wrestling a mountain of paperwork and bills. Watched this process with sick relatives in the 90s, and it was already fucked-up then. Gone through it with my wife's 3 pregnancies and a couple family illnesses in the last 5ish years. Same thing. It's a broken, evil system that ruthlessly exploits and crushes anyone without the time, wits, and wherewithal to fight it every step, and it has been for a long time. I think what changed is we have much better exposure to what it's like elsewhere, so more of us are aware that there is no reason whatsoever to keep hurting people this way.

drzaiusapelord 9y ago

Well, you can buy partly subsidized or receive fully subsidized healthcare (ACA/Medicaid). That's on top of programs like COBRA and in worst case scenarios welfare from the state, county, or federal levels. We also have CHIP on the federal level which is a separate program just for children, where the parents may have insurance but for some reason cannot insure their kids. That's on top of what the states themselves offer, but that's sort of rolled into the ACA nowadays, which makes more sense. We're at 8% uninsured, which is nothing to brag about, but its far from a free for all post-apocalypse where people keel over in their desks or in the unemployment line. Its also important to note that those numbers include illegals who can't or won't get insurance due to citizen status and 1/3rd to 2/3rd of that number actually qualify for various insurance programs, but for some reason aren't seeking it (aside from citizen status). We absolutely have a big problem with the rural poor and insurance, which is a hefty 14-20% of that demographic. I'm not sure what the fix here is especially considering rural states are heavily conservative and fight off ACA and Medicare/Medicaid expansion regularly.

ChemicalWarfare 9y ago
upvoted. as far as the rural areas vs ACA are concerned - before ACA a lumberjack/construction/handyman/hunting-fishing guide etc type dude could by themselves cheap health insurance that wouldn't break the bank off-season. now it's an ordeal.
- drzaiusapelord 9y ago
  The problem there is that low rent health insurance didn't cover anything. You'd had catastrophic plans with $2,500+ deductibles and a cap at $25k. It didn't cover preventative maintenance, doctor visits, kids, drugs, etc. It only made sense in a "what if I injure myself at work, but not too seriously" kind of way. I imagine ACA mandated insurance is a net boon here even if the monthlies are more.

kobeya 9y ago

You walk into an emergency room and get treated without paying a cent.

wil421 9y ago
Seriously, if I believe what everyone comments on HN I would think hospitals are turning sick or injured people away.
- kobeya 9y ago
  My mama taught me to not talk about things I don't know anything about. I wish more people listened to their mamas. To the curious Europeans out there, if you lose your job you can stay on your job's health plan for 18 months while you look for new work. If you're unemployed that long then you'd qualify for Medicaid after that, the government insurance program for the poor. If for whatever reason you really didn't have insurance you will nevertheless never be turned away from any hospital emergency room. This "die in he street because you have no insurance" is a myth and total hogwash.
  - pkaye 9y ago
    Make sure mama also told you these two things... Cobra insurance after losing your job requires you to pay the full premium which can be upwards of 10k per year. Also Medicaid has a very low asset threshold that you can still qualify unless you are pregnant, have young kids, disabled or elderly. ACA subsidy is the best shot for most in this situation but who knows how long till it is dismantled.
  - dkonofalski 9y ago
    It's not hogwash when actual, documented cases exist of people not going to the emergency room for fear of being crushed to death by the debt from an ER visit. And COBRA doesn't just give you free insurance for 18 months, you have to pay the full premium for it. If you're unemployed, how in the hell do you expect to pay the full premium as opposed to the premium that you were paying before that was subsidized by your employer? You've clearly never, ever been in a position where money was an issue for you. Especially not to the point where you felt your life was in danger because of it.