8 ms·

I hope the US Federal Government does something to fix the situation for Healthcare. Healthcare and Education seem like the biggest issues in the US currently,

I hope the US Federal Government does something to fix the situation for Healthcare. Healthcare and Education seem like the biggest issues in the US currently, just being unlucky on either aspect, even if you make amazing money can throw you into poverty it seems.. seems like a horrible way to live in constant fear.

jermaustin1 7y ago
As a consultant, with a couple of monthly prescriptions (thyroid, asthma, allergies), and a wife with a couple of monthly prescriptions (allergies, asthma), we pay just under $2000/mo for insurance, then about $200 every few months for doctor bills, and around $150/mo for all of our prescriptions. All in all, we spend about half the median household income each year in health care. When my wife got pneumonia after the flu, we had to drop thousands on an ER visit. If I wasn't well paid, between our allergies and asthma, we'd probably dead.
- Mirioron 7y ago
  This is the crazy part to me. You have private insurance, but the quality of the insurance is so piss poor that one wonders what the point of it is in the first place. Nothing seems to ever be fully covered under it.
  - lotsofpulp 7y ago
    The insurance is there to pay for the $20k+ heart attacks, premature babies needing NICU at probably $100k+, hemophilics needing $500k+ medications, etc. Also, if you're young, you're subsidizing healthcare for the old. If you're not poor (per government definition) and don't qualify for health insurance premium tax credits, then you're subsidizing them too. And if you're a male, you're subsidizing childbirth and other women specific costs. And who knows what else. In other words, it's the same as a tax to pay for healthcare for the country, except it goes to insurance companies, and you have to deal with in network and out of network. Except this tax goes up the older you get (but capped at 3x what youngest/healthiest person pays). Presumably, if you add up all the insurance premiums paid for every year of a person's life, it should theoretically add up to close to how much the insurance company expects to spend on you (plus some profit, capped at 20% by ACA).
    - uoaei 7y ago
      The biggest joke is that Americans think that the amounts they are charged for healthcare services is what those services really cost to administer. It's really not even close. A heart attack does not cost $20k+ to treat in other developed countries. A broken arm costs maybe $200 equivalent in the UK vs multiple thousands in the US. I'm not talking about how much the patient is charged, I'm talking about paying the doctors for their time and affording the equipment to perform the treatment. There's always the anecdata that floats around the internet claiming that you can fly to Spain, live their for 6 months, get a hip replacement, and fly back to the US for the same amount as the outpatient surgery costs in the US. It's basically true, though the numbers may have drifted slightly since it first started making the rounds. > it's the same as a tax to pay for healthcare for the country, except it goes to insurance companies, and you have to deal with in network and out of network I think this is one of the strongest ways to frame government-provided healthcare. It's no different paying a tax vs paying the company directly, and in the former case you have the whole US government bargaining on your behalf for reasonable healthcare costs (in the case of single-payer a la M4A). > capped at 20% by ACA 20% is a lot when we're talking about these outrageous numbers.
      - lotsofpulp 7y ago
        > 20% is a lot when we're talking about these outrageous numbers. It’s not 20% net income, it’s 80% of premiums have to be paid out to healthcare providers. There’s still all the costs of operating the insurance organization, and financials of publicly listed health insurance companies show net income in the 3% to 6% range.
    - jermaustin1 7y ago
      Take the NHS in the United Kingdom. For my high wage, my NHS fee would be just under £7k for the year, my taxes just about at 30%. Granted here in the US, my taxes are ONLY 25%, but my healthcare costs are close to $30k/year. That $20k difference is ridiculous ($11k more than in the UK when comparing tax+health), and I HAVEN'T gone to the hospital for a heart attack or premature baby or hemophilia, but if my wife did have a baby, it would cost us out of pocket around $8k (according to the likely VERY skewed numbers in my insurance packet). A colleague I know is 54, he is single, has only catastrophic coverage and pays $1200/mo. Nothing is covered except 40% of any emergency hospitalizations. The bronze plan was $2000 and had a $15k deductible, and also was basically only co-insurance with $30 generics. The way we are doing this here in the US is literally killing people. Medical debt is increasing. My little sister-in-law was on vacation and walking along a path on a jetty with handrails, and benches, and dozens of other people. A rogue wave came and hit her and her friend. She was taken under, knocked unconscious and drowned (and died), until a random stranger who was standing near her finally found her and resuscitated her. She was medivaced to a hospital by helicopter that insurance only covered 10% of because she was out of network, she was then treated by a dozen or so doctors for multiple days as she got pneumonia and broken bones, and head trauma, all out of network. She ended up owing close to $100k with her insurance only covering the first $25k. In any other first-world country, she'd be out of pocket maybe a few hundred bucks. Not in collections for being unable to pay $75k for a freak accident.
- zrail 7y ago
  This is where my family was in 2017. In 2018 I took a FT job with my biggest client when they offered to pay 100% of a significantly better health plan for my entire family. I didn't regret it then and I don't regret it now.
  - uoaei 7y ago
    Congrats, sincerely, but it seems very wrong that an arrangement can exist where if you lose or leave your current job, you might die.
    - zrail 7y ago
      In the US if you leave your job for any reason you don't lose your insurance. You have access to the same plan for at least 18 months (some situations up to 36 months) through a law named COBRA. You have to pay all the premiums but that's what an emergency fund is for.
      - learc83 7y ago
        Under COBRA, you have to pay the employee portion plus a 2% administration fee, which means that for the average family you'll be paying 3x to 4x as much.
      - usefulcat 7y ago
        That doesn't address the underlying problem, namely the absolutely bat-shit insanely high cost of health care in the US. I have the cheapest family plan I can get. It comes with a ~$12k annual deductible and still manages to cost more than my mortgage every month.
      - FireBeyond 7y ago
        How many families have an emergency fund that can cope with: rent/mortgage, car, utilities, and $2,000+/mo healthcare in the event of unemployment?
- metalliqaz 7y ago
  if you weren't well paid, you could be one of the various state/federal welfare programs such as Medicaid and your bills would be much, much lower
  - learc83 7y ago
    In most states to qualify for that you have to be very poorly paid. And in many states, like Georgia for instance, Medicaid covers needy children, pregnant women, parents/caretakers, elderly, disabled and blind residents and people in need of nursing home care. Good luck if you fall outside of that list.
    - metalliqaz 7y ago
      Indeed. Don't live in Georgia.
      - learc83 7y ago
        Unfortunately the people who are most impacted by this are the people who are least able to afford the move to another state. Especially when nearly every state in the south decided not to expand medicaid.
  - heavyset_go 7y ago
    Depends on where they live[1], there are several states that didn't expand Medicaid under the ACA. They'd also have to make under 100-138% of the federal poverty level, which is ~$12,490-17,236.20 for individuals and ~$16,910-23,335.80 for couples. [1] https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/ https://www.kff.org/medicaid/issue-brief/status-of-state-med...
metalliqaz 7y ago
healthcare is getting so bad that eventually medicare for all will be a republican position too. They will call it something else, but it will happen. the party has fundamentally changed. Oligarchs know that money has to be spent to keep the plebs just well enough to prevent revolt.
- FireBeyond 7y ago
  > medicare for all will be a republican position too. They will call it something else There was a survey that went around a few years, asking Republican voters something along the lines of: "Would you vote for an Affordable Care Act if it was offered as an alternative to Obamacare?" A significant amount said "Yes".
  - xtian 7y ago
    There was also a survey (not filtered by party affiliation) asking if people would support a single-payer program with an elimination of private insurance. A majority said "Yes."
- Mirioron 7y ago
  I think so too. The main thing is that it might even lower how much money is paid for that healthcare system in total.
- heavyset_go 7y ago
  Unfortunately, there is no evidence of this, especially when Republicans recently took away food stamps people rely on to feed themselves. Can't revolt if you're disabled and untreated, tied to your job to keep your kids healthy, incapacitated by treatable illness or weak from hunger.
  - metalliqaz 7y ago
    yeah we have a few more years yet before the turn of the tide, but I remain confident it will happen
jefurii 7y ago
I wish we could see promotion of good health and good education as investments in our country.

jermaustin1 7y ago

As a consultant, with a couple of monthly prescriptions (thyroid, asthma, allergies), and a wife with a couple of monthly prescriptions (allergies, asthma), we pay just under $2000/mo for insurance, then about $200 every few months for doctor bills, and around $150/mo for all of our prescriptions. All in all, we spend about half the median household income each year in health care. When my wife got pneumonia after the flu, we had to drop thousands on an ER visit. If I wasn't well paid, between our allergies and asthma, we'd probably dead.

Mirioron 7y ago
This is the crazy part to me. You have private insurance, but the quality of the insurance is so piss poor that one wonders what the point of it is in the first place. Nothing seems to ever be fully covered under it.
- lotsofpulp 7y ago
  The insurance is there to pay for the $20k+ heart attacks, premature babies needing NICU at probably $100k+, hemophilics needing $500k+ medications, etc. Also, if you're young, you're subsidizing healthcare for the old. If you're not poor (per government definition) and don't qualify for health insurance premium tax credits, then you're subsidizing them too. And if you're a male, you're subsidizing childbirth and other women specific costs. And who knows what else. In other words, it's the same as a tax to pay for healthcare for the country, except it goes to insurance companies, and you have to deal with in network and out of network. Except this tax goes up the older you get (but capped at 3x what youngest/healthiest person pays). Presumably, if you add up all the insurance premiums paid for every year of a person's life, it should theoretically add up to close to how much the insurance company expects to spend on you (plus some profit, capped at 20% by ACA).
  - uoaei 7y ago
    The biggest joke is that Americans think that the amounts they are charged for healthcare services is what those services really cost to administer. It's really not even close. A heart attack does not cost $20k+ to treat in other developed countries. A broken arm costs maybe $200 equivalent in the UK vs multiple thousands in the US. I'm not talking about how much the patient is charged, I'm talking about paying the doctors for their time and affording the equipment to perform the treatment. There's always the anecdata that floats around the internet claiming that you can fly to Spain, live their for 6 months, get a hip replacement, and fly back to the US for the same amount as the outpatient surgery costs in the US. It's basically true, though the numbers may have drifted slightly since it first started making the rounds. > it's the same as a tax to pay for healthcare for the country, except it goes to insurance companies, and you have to deal with in network and out of network I think this is one of the strongest ways to frame government-provided healthcare. It's no different paying a tax vs paying the company directly, and in the former case you have the whole US government bargaining on your behalf for reasonable healthcare costs (in the case of single-payer a la M4A). > capped at 20% by ACA 20% is a lot when we're talking about these outrageous numbers.
    - lotsofpulp 7y ago
      > 20% is a lot when we're talking about these outrageous numbers. It’s not 20% net income, it’s 80% of premiums have to be paid out to healthcare providers. There’s still all the costs of operating the insurance organization, and financials of publicly listed health insurance companies show net income in the 3% to 6% range.
  - jermaustin1 7y ago
    Take the NHS in the United Kingdom. For my high wage, my NHS fee would be just under £7k for the year, my taxes just about at 30%. Granted here in the US, my taxes are ONLY 25%, but my healthcare costs are close to $30k/year. That $20k difference is ridiculous ($11k more than in the UK when comparing tax+health), and I HAVEN'T gone to the hospital for a heart attack or premature baby or hemophilia, but if my wife did have a baby, it would cost us out of pocket around $8k (according to the likely VERY skewed numbers in my insurance packet). A colleague I know is 54, he is single, has only catastrophic coverage and pays $1200/mo. Nothing is covered except 40% of any emergency hospitalizations. The bronze plan was $2000 and had a $15k deductible, and also was basically only co-insurance with $30 generics. The way we are doing this here in the US is literally killing people. Medical debt is increasing. My little sister-in-law was on vacation and walking along a path on a jetty with handrails, and benches, and dozens of other people. A rogue wave came and hit her and her friend. She was taken under, knocked unconscious and drowned (and died), until a random stranger who was standing near her finally found her and resuscitated her. She was medivaced to a hospital by helicopter that insurance only covered 10% of because she was out of network, she was then treated by a dozen or so doctors for multiple days as she got pneumonia and broken bones, and head trauma, all out of network. She ended up owing close to $100k with her insurance only covering the first $25k. In any other first-world country, she'd be out of pocket maybe a few hundred bucks. Not in collections for being unable to pay $75k for a freak accident.
zrail 7y ago
This is where my family was in 2017. In 2018 I took a FT job with my biggest client when they offered to pay 100% of a significantly better health plan for my entire family. I didn't regret it then and I don't regret it now.
- uoaei 7y ago
  Congrats, sincerely, but it seems very wrong that an arrangement can exist where if you lose or leave your current job, you might die.
  - zrail 7y ago
    In the US if you leave your job for any reason you don't lose your insurance. You have access to the same plan for at least 18 months (some situations up to 36 months) through a law named COBRA. You have to pay all the premiums but that's what an emergency fund is for.
    - learc83 7y ago
      Under COBRA, you have to pay the employee portion plus a 2% administration fee, which means that for the average family you'll be paying 3x to 4x as much.
    - usefulcat 7y ago
      That doesn't address the underlying problem, namely the absolutely bat-shit insanely high cost of health care in the US. I have the cheapest family plan I can get. It comes with a ~$12k annual deductible and still manages to cost more than my mortgage every month.
    - FireBeyond 7y ago
      How many families have an emergency fund that can cope with: rent/mortgage, car, utilities, and $2,000+/mo healthcare in the event of unemployment?
metalliqaz 7y ago
if you weren't well paid, you could be one of the various state/federal welfare programs such as Medicaid and your bills would be much, much lower
- learc83 7y ago
  In most states to qualify for that you have to be very poorly paid. And in many states, like Georgia for instance, Medicaid covers needy children, pregnant women, parents/caretakers, elderly, disabled and blind residents and people in need of nursing home care. Good luck if you fall outside of that list.
  - metalliqaz 7y ago
    Indeed. Don't live in Georgia.
    - learc83 7y ago
      Unfortunately the people who are most impacted by this are the people who are least able to afford the move to another state. Especially when nearly every state in the south decided not to expand medicaid.
- heavyset_go 7y ago
  Depends on where they live[1], there are several states that didn't expand Medicaid under the ACA. They'd also have to make under 100-138% of the federal poverty level, which is ~$12,490-17,236.20 for individuals and ~$16,910-23,335.80 for couples. [1] https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/ https://www.kff.org/medicaid/issue-brief/status-of-state-med...

metalliqaz 7y ago

healthcare is getting so bad that eventually medicare for all will be a republican position too. They will call it something else, but it will happen. the party has fundamentally changed. Oligarchs know that money has to be spent to keep the plebs just well enough to prevent revolt.

FireBeyond 7y ago
> medicare for all will be a republican position too. They will call it something else There was a survey that went around a few years, asking Republican voters something along the lines of: "Would you vote for an Affordable Care Act if it was offered as an alternative to Obamacare?" A significant amount said "Yes".
- xtian 7y ago
  There was also a survey (not filtered by party affiliation) asking if people would support a single-payer program with an elimination of private insurance. A majority said "Yes."
Mirioron 7y ago
I think so too. The main thing is that it might even lower how much money is paid for that healthcare system in total.
heavyset_go 7y ago
Unfortunately, there is no evidence of this, especially when Republicans recently took away food stamps people rely on to feed themselves. Can't revolt if you're disabled and untreated, tied to your job to keep your kids healthy, incapacitated by treatable illness or weak from hunger.
- metalliqaz 7y ago
  yeah we have a few more years yet before the turn of the tide, but I remain confident it will happen

jefurii 7y ago

I wish we could see promotion of good health and good education as investments in our country.