21 ms·

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group i

by acabal 16y ago

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group insurance. But I really only make enough to live frugally and save a tiny amount each month--to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. But not only would it not happen at that price, but as the article says, it wouldn't happen period--even though I'm a healthy, nonsmoking, active 26-year-old male, I've had cubital tunnel problems in the past (typing) and surgery on my wrist (badly broken in an accident). If I applied, I would surely be denied--and again, as the article states, if you're denied once, your chances of being accepted in the future just dropped by a big percentage. It literally makes more financial sense for me to pay minor expenses out of pocket and declare bankruptcy in the chance of crippling bills than to be insured. Healthcare in America is utterly, utterly broken; it's damaging poor, middle-class, and rich people alike, and stifling innovation. I have the ability to innovate with my company because I'm young, single, and healthy; but many smart people have existing medical problems, families, or other factors that make them indentured servants to the company that pays their healthcare. As a nation we're under the thumb of the insurance companies, and instead of doing anything serious about it, we've done almost the worst possible option: require every one of us to be a customer of these monstrous companies, with little regulation on cost or other government oversight. I'm the first person to back health insurance reform, but we've reformed it in the name of shoveling more money into the pockets of industry instead of for regular people needing real care. It's crap like this that's compelling me to make my current expat lifestyle permanent. America might still get the tax dollars my business generates (the only country to still tax you if you live abroad) but it won't get my brain or my talent within its borders.

WalterBright 16y ago
"For fun, let’s imagine confiscating all the profits of all the famously greedy health-insurance companies. That would pay for four days of health care for all Americans." http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/3/ http://www.theatlantic.com/magazine/archive/2009/09/how-amer... Insurance company profits are not the problem.
elai 16y ago
Per capita spending on health care in more sane developed countries in the world is about $4000/yr. To get your so-so full service health care, the sane market price is about $333/month, and in most of those systems, medication isn't covered fully if you have an income. $50-$100 month just doesn't work other than emergency health care. Emergency plans at that price also have clauses like the first $2500 of an accident is deductible free.
tptacek 16y ago
Let's keep perspective here. Because, your critique of the health insurance system seems to simultaneously affirm and entirely miss the point of the article. A close read of your first three grafs --- the only ones that respond to the article --- suggests that you wish you could get something better than "car-crash-emergency" insurance for 50-100. Well. Let's unpack what you're missing here. (1) The author of this article, like my own family, can't get "car-crash-emergency" insurance for 50, 100, or 500 dollars a month. Never mind the deductable. If your records include a shred of evidence of 150+ seemingly-random conditions†, you're an automatic decline. That's the problem the article is bringing up. (2) A system in which only "car-crash-emergency" care was automatically covered would be workable; a vast improvement over what we have today! Outside of car crashes and appendicitis††, you in fact don't spend $1200/year on health care. We're a family of four, and we don't spend $1200/year on health care, let alone $4800/year or (gak) the significantly greater amount we really spend on the low-deductable group coverage we set up for Matasano. A $5k deductable would suit us just fine; we'd save, significantly, simply by plowing the money we would have spent on crazy bullshit low-deductable insurance into an interest-bearing vehicle and shelling out from it when we actually needed care, all the while secure in the knowledge that when someone ends up in the ICU, our liability is capped. Not for nothing, but this is a scheme that both Dems and Republicans buy into. Health care in America is broken. But it's not "utterly, utterly" broken. Whatever the number of random medical bk's we have in the US, it's too high. But we don't need to transform our health insurance system into the National Health or the French system. We are epsilon away from a Swiss-style system of mandatory and guaranteed-issue private insurance. † http://www.thecasongroup.com/forms/enrollment/Humana/H1%20Underwriting%20Guide%2010_2009.pdf http://www.thecasongroup.com/forms/enrollment/Humana/H1%20Un... . †† Many tens of thousands of dollars. Happened to a friend.
mattjaynes 16y ago
"instead of doing anything serious about it, we've done almost the worst possible option: require every one of us to be a customer of these monstrous companies, with little regulation on cost or other government oversight" This is a common misunderstanding of the economics of this situation. The principle involved here is "Adverse Selection". To illustrate, let's look at automobile liability insurance. The reason this insurance is so affordable for most americans is that 1) everyone with a car must pay it and 2) there is price competition among insurers. Imagine for a moment that automobile liability insurance was optional. Who would benefit the most from having this insurance? Accident-prone drivers or non-accident-prone drivers? That's right - the accident-prone drivers. And since accident-prone drivers have the most incentive to have liability insurance, you would see the customer pool of the insurance start skewing heavily towards these high-risk drivers. Then, since it's mostly the high-risk drivers in the customer pool, the number of claim payouts would go dramatically up along with the average payout per claim. In order for the insurance company to remain in business they would be forced to raise their rates OR to be super strict about not insuring customers that seem risky. Naturally, the insurance business only works if you have more money coming in than going out. And in order for the insurance to be "affordable" to most people, then the risk needs to be spread amongst most people (not just the more risky ones). So, while I understand and share your frustration at the current state of health care in the U.S. - it's important to point out "why" everyone needs to be insured in order for the rates to be "affordable". Of course there are other important variables affecting health insurance premium rates (rising health care costs is a major one), but the "Adverse Selection" issue is probably the most important. ----- Another point to consider is that the current big health insurance companies have focused their skill on just a couple things: 1. Avoiding risky customers (by denying them or offering only super-high premiums) 2. Paying out as little as possible (by reducing health care costs and denying claims) The dynamics of the health insurance market are about to be dramatically changed. #1 will no longer be nearly as important and there will be a huge jump in the size of the market. This will be a huge opportunity for disruption in the industry. The old health care companies are extremely slow, bloated, and resistant to change. It's easy to see that new entrants will be able to grab significant market share from them and initiate some real price competition. It's frustrating to have to wait the few years until this happens, but I'm very optimistic about the future (assuming the recent health care reforms won't be diluted before they can be enacted).
detst 16y ago
Have you looked into this (for California but there are different plans in every other state)? http://www.healthcare.gov/law/provisions/preexisting/states/ca.html http://www.healthcare.gov/law/provisions/preexisting/states/... "$499 for a 50 year old subscriber in San Francisco" Looking at other states, there are premiums as low as $172/month. It would surely be much cheaper for you as a 26-year-old. Not quite the $50-100 you're looking for but I'd bet you could afford it. Things are bad but maybe not as bad for you as you think.
- acabal 16y ago
  This looks like a good resource--thanks for that. Right now my current location is Monterrey, Mexico, so again, doctor visits are cheaper to simply pay out of pocket. As an example, my uninsured girlfriend had to visit a doctor last week--a walk in appointment at the major Monterrey hospital plus lab test, technician, and prescription medication: 800 pesos, or about $66. And this is in a modern hospital in the most expensive city in Mexico.
- encoderer 16y ago
  I'm 28 in Florida. I have a very decent plan for $75 a month. I have to pay for office vists (tho I am reimbused $50 for each one, they're usually around $125 or so) but i have a very low deductible that will cover me for any major illness or accident, and even for services beyond my coverage I get the benefit of the lower negotiated insurance company rates. You can see these plans for yourself by checking our Blue Cross or Humana in Florida, among others.
  - kenjackson 16y ago
    Wow, for a family of five I pay $1200/month. And not a very low deductible. Also Blue Cross... go figure.
    - dgabriel 16y ago
      I pay about $550/mo for the 5 of us, but that's just because my employer pays 2/3s of the cost.
Groxx 16y ago
>to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But think about the costs of such a system, regardless of inefficiencies / the problems of the current system that make things cost hundreds of thousands: Doctors and nurses and supporting staff must exist. So must hospitals. They are highly trained, and will be expensive - period. They also have to keep learning, so they can't be busy making money all the time. And they must have such people available all the time, or people die. Given that, and the equipment and check-up and hospital time, how much should a minor surgery cost? Not in cost to you, in cost. If the cost to you is mitigated in any way, it's extracted another way (taxes). I'd have trouble seeing it cost less than a few thousand dollars in the best, highly-used system. That's a lot of training and a lot of supporting necessities for any random surgery. At $50-100/month, they would have to sap you for nearly a decade to make up a single surgery. It might even out for the insurance company if that was it - but certainly not when you get older, and not with any kind of routine, preventative care. Scale that up to emergency situations where major surgery and years of rehab for even 0.1% of the people they're covering - how many hundreds of years does that cost everyone on the plan? Cataclysmic health insurance is cheap because it only covers cataclysms. Because one in a hundred lives cost an utterly enormous amount more than a single person generates. --- None of this is to say that I think the healthcare system is efficient by any means, nor not full of corruption, waste, frivolous lawsuits, or damaging dogma. Merely that there is simply a bottom limit that the prices that people want to pay will never be able to support, unless all cataclysmic protection is dropped. And would you rather die from a car crash, or be rehab'd for a couple years and continue your life for another 60 years? So people choose the cataclysmic protection, and prices jump. --- edit: because this seems it will come up often, some evidence for my claim based on Canada's setup, copied from another comment I made below: http://en.wikipedia.org/wiki/Health_care_in_Canada http://en.wikipedia.org/wiki/Health_care_in_Canada >In 2009, the government funded about 70% of Canadians' health care costs. >Per capita expenditure in 2009: 3,895 $227 per month, per person, comes from the government, which means it comes from taxes. And an additional $100 per person is spent per month on average ($324.58 per month). Far in excess of $50-$100.
troels 16y ago
> the only country to still tax you if you live abroad Not that it has anything to do with the main subject, but that is not true. Other countries tax their expat citizens.
sethg 16y ago
FWIW, I went to the Web site that Massachusetts residents use to find affordable health-care programs. For someone of my age and zip code buying insurance for just myself, the premiums started at $272. (In Massachusetts just about everyone must have health insurance and insurers may not discriminate based on pre-existing conditions. Households making less than triple the Federal poverty rate get subsidized plans.) https://www.mahealthconnector.org/portal/site/connector/ https://www.mahealthconnector.org/portal/site/connector/
WalterBright 16y ago
Here's why it's broken. It's a long read, but worth it. The reasons are not what you'd expect, and not what you usually hear. http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/ http://www.theatlantic.com/magazine/archive/2009/09/how-amer...
- zach 16y ago
  You beat me to it! Fantastic article from a former startup CEO (I worked for him about 10 years ago). I thought I had heard all the arguments before I read it.
jasonkester 16y ago
to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. Actually, that's exactly the policy you want as a healthy 26 year old: $5,000 deductible catastrophic coverage, and nothing more. It'll cost you $86 per month from Blue Shield. Health insurance, in the sense that you see it in group policies from your employer, is not worth the cost if you're buying it yourself. It will be 15 years before you get to the point where a $50 copay and low deductible make sense. Think about it. How often are you at the doctor? Once a year? Once every 3 years? And it costs you a hundred bucks or so. That's not something you need to be insuring yourself against. The key is to keep a bit of insurance just in case you get in that car crash and need new hip joints, or if you suddenly develop bone cancer and are looking at $10k/month health care bills. Those things are crazy rare, and the policy that protects you against them is priced accordingly.
- cookiecaper 16y ago
  I guess you may be much healthier than the people I know, but I don't think I know very many people who go three years without a visit to the doctor. We all get infections that are considered minor and routine due to our medical care, but if we can't get that medical care they can be life-threatening, like strep throat or other common winter ailments. We all sometimes have accidents and trip and need to go to the hospital. There are lots of other things. Counting on visiting only once every three years is a bit dangerous imo.
  - jasonkester 16y ago
    I remember exactly one doctor's visit in my 20s (bad dose of poison oak), one in my early 30s (bad bouldering fall), then nothing until age 39. So yeah, your mileage may vary. Needless to say, I never came close to hitting my $5k deductible. (or even my $250 annual deductible in the years when I had company-sponsored insurance).
thangalin 16y ago
In Canada, I pay $60.50 per month (was recently $57) into our Medical Services Plan: http://www.health.gov.bc.ca/msp/infoben/premium.html http://www.health.gov.bc.ca/msp/infoben/premium.html The West Coast, by the way, is beautiful. Vancouver BC and Seattle WA are practically sibling cities. Apply for citizenship. We'd love to have you!
steipete 16y ago
In austria, if you have your own business, you have to pay for the state own insurance company a part of your total income, which is usually a beween a few hundredths and thousand bucks PER MONTH. So don't argue with $50-$100 a month.
mbesto 16y ago
American expat in London here. Can't agree more. Healthy 26 year old with no conditions. I don't need NHS and don't mind pay taxes for it. I want to know it's there when I do need it though.
api 16y ago
What we have is everything that is bad about a private healthcare system combined with everything that is bad about socialized medicine. Over-regulation, high cost, and impossible to get without an employer or some other kind of large group. The American system benefits only one group: insurance companies.

by acabal 16y ago

WalterBright 16y ago

"For fun, let’s imagine confiscating all the profits of all the famously greedy health-insurance companies. That would pay for four days of health care for all Americans." http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/3/ http://www.theatlantic.com/magazine/archive/2009/09/how-amer... Insurance company profits are not the problem.

elai 16y ago

Per capita spending on health care in more sane developed countries in the world is about $4000/yr. To get your so-so full service health care, the sane market price is about $333/month, and in most of those systems, medication isn't covered fully if you have an income. $50-$100 month just doesn't work other than emergency health care. Emergency plans at that price also have clauses like the first $2500 of an accident is deductible free.

tptacek 16y ago

Let's keep perspective here. Because, your critique of the health insurance system seems to simultaneously affirm and entirely miss the point of the article. A close read of your first three grafs --- the only ones that respond to the article --- suggests that you wish you could get something better than "car-crash-emergency" insurance for 50-100. Well. Let's unpack what you're missing here. (1) The author of this article, like my own family, can't get "car-crash-emergency" insurance for 50, 100, or 500 dollars a month. Never mind the deductable. If your records include a shred of evidence of 150+ seemingly-random conditions†, you're an automatic decline. That's the problem the article is bringing up. (2) A system in which only "car-crash-emergency" care was automatically covered would be workable; a vast improvement over what we have today! Outside of car crashes and appendicitis††, you in fact don't spend $1200/year on health care. We're a family of four, and we don't spend $1200/year on health care, let alone $4800/year or (gak) the significantly greater amount we really spend on the low-deductable group coverage we set up for Matasano. A $5k deductable would suit us just fine; we'd save, significantly, simply by plowing the money we would have spent on crazy bullshit low-deductable insurance into an interest-bearing vehicle and shelling out from it when we actually needed care, all the while secure in the knowledge that when someone ends up in the ICU, our liability is capped. Not for nothing, but this is a scheme that both Dems and Republicans buy into. Health care in America is broken. But it's not "utterly, utterly" broken. Whatever the number of random medical bk's we have in the US, it's too high. But we don't need to transform our health insurance system into the National Health or the French system. We are epsilon away from a Swiss-style system of mandatory and guaranteed-issue private insurance. † http://www.thecasongroup.com/forms/enrollment/Humana/H1%20Underwriting%20Guide%2010_2009.pdf http://www.thecasongroup.com/forms/enrollment/Humana/H1%20Un... . †† Many tens of thousands of dollars. Happened to a friend.

mattjaynes 16y ago

"instead of doing anything serious about it, we've done almost the worst possible option: require every one of us to be a customer of these monstrous companies, with little regulation on cost or other government oversight" This is a common misunderstanding of the economics of this situation. The principle involved here is "Adverse Selection". To illustrate, let's look at automobile liability insurance. The reason this insurance is so affordable for most americans is that 1) everyone with a car must pay it and 2) there is price competition among insurers. Imagine for a moment that automobile liability insurance was optional. Who would benefit the most from having this insurance? Accident-prone drivers or non-accident-prone drivers? That's right - the accident-prone drivers. And since accident-prone drivers have the most incentive to have liability insurance, you would see the customer pool of the insurance start skewing heavily towards these high-risk drivers. Then, since it's mostly the high-risk drivers in the customer pool, the number of claim payouts would go dramatically up along with the average payout per claim. In order for the insurance company to remain in business they would be forced to raise their rates OR to be super strict about not insuring customers that seem risky. Naturally, the insurance business only works if you have more money coming in than going out. And in order for the insurance to be "affordable" to most people, then the risk needs to be spread amongst most people (not just the more risky ones). So, while I understand and share your frustration at the current state of health care in the U.S. - it's important to point out "why" everyone needs to be insured in order for the rates to be "affordable". Of course there are other important variables affecting health insurance premium rates (rising health care costs is a major one), but the "Adverse Selection" issue is probably the most important. ----- Another point to consider is that the current big health insurance companies have focused their skill on just a couple things: 1. Avoiding risky customers (by denying them or offering only super-high premiums) 2. Paying out as little as possible (by reducing health care costs and denying claims) The dynamics of the health insurance market are about to be dramatically changed. #1 will no longer be nearly as important and there will be a huge jump in the size of the market. This will be a huge opportunity for disruption in the industry. The old health care companies are extremely slow, bloated, and resistant to change. It's easy to see that new entrants will be able to grab significant market share from them and initiate some real price competition. It's frustrating to have to wait the few years until this happens, but I'm very optimistic about the future (assuming the recent health care reforms won't be diluted before they can be enacted).

detst 16y ago

Have you looked into this (for California but there are different plans in every other state)? http://www.healthcare.gov/law/provisions/preexisting/states/ca.html http://www.healthcare.gov/law/provisions/preexisting/states/... "$499 for a 50 year old subscriber in San Francisco" Looking at other states, there are premiums as low as $172/month. It would surely be much cheaper for you as a 26-year-old. Not quite the $50-100 you're looking for but I'd bet you could afford it. Things are bad but maybe not as bad for you as you think.

acabal 16y ago
This looks like a good resource--thanks for that. Right now my current location is Monterrey, Mexico, so again, doctor visits are cheaper to simply pay out of pocket. As an example, my uninsured girlfriend had to visit a doctor last week--a walk in appointment at the major Monterrey hospital plus lab test, technician, and prescription medication: 800 pesos, or about $66. And this is in a modern hospital in the most expensive city in Mexico.
encoderer 16y ago
I'm 28 in Florida. I have a very decent plan for $75 a month. I have to pay for office vists (tho I am reimbused $50 for each one, they're usually around $125 or so) but i have a very low deductible that will cover me for any major illness or accident, and even for services beyond my coverage I get the benefit of the lower negotiated insurance company rates. You can see these plans for yourself by checking our Blue Cross or Humana in Florida, among others.
- kenjackson 16y ago
  Wow, for a family of five I pay $1200/month. And not a very low deductible. Also Blue Cross... go figure.
  - dgabriel 16y ago
    I pay about $550/mo for the 5 of us, but that's just because my employer pays 2/3s of the cost.

Groxx 16y ago

>to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But think about the costs of such a system, regardless of inefficiencies / the problems of the current system that make things cost hundreds of thousands: Doctors and nurses and supporting staff must exist. So must hospitals. They are highly trained, and will be expensive - period. They also have to keep learning, so they can't be busy making money all the time. And they must have such people available all the time, or people die. Given that, and the equipment and check-up and hospital time, how much should a minor surgery cost? Not in cost to you, in cost. If the cost to you is mitigated in any way, it's extracted another way (taxes). I'd have trouble seeing it cost less than a few thousand dollars in the best, highly-used system. That's a lot of training and a lot of supporting necessities for any random surgery. At $50-100/month, they would have to sap you for nearly a decade to make up a single surgery. It might even out for the insurance company if that was it - but certainly not when you get older, and not with any kind of routine, preventative care. Scale that up to emergency situations where major surgery and years of rehab for even 0.1% of the people they're covering - how many hundreds of years does that cost everyone on the plan? Cataclysmic health insurance is cheap because it only covers cataclysms. Because one in a hundred lives cost an utterly enormous amount more than a single person generates. --- None of this is to say that I think the healthcare system is efficient by any means, nor not full of corruption, waste, frivolous lawsuits, or damaging dogma. Merely that there is simply a bottom limit that the prices that people want to pay will never be able to support, unless all cataclysmic protection is dropped. And would you rather die from a car crash, or be rehab'd for a couple years and continue your life for another 60 years? So people choose the cataclysmic protection, and prices jump. --- edit: because this seems it will come up often, some evidence for my claim based on Canada's setup, copied from another comment I made below: http://en.wikipedia.org/wiki/Health_care_in_Canada http://en.wikipedia.org/wiki/Health_care_in_Canada >In 2009, the government funded about 70% of Canadians' health care costs. >Per capita expenditure in 2009: 3,895 $227 per month, per person, comes from the government, which means it comes from taxes. And an additional $100 per person is spent per month on average ($324.58 per month). Far in excess of $50-$100.

troels 16y ago

> the only country to still tax you if you live abroad Not that it has anything to do with the main subject, but that is not true. Other countries tax their expat citizens.

sethg 16y ago

FWIW, I went to the Web site that Massachusetts residents use to find affordable health-care programs. For someone of my age and zip code buying insurance for just myself, the premiums started at $272. (In Massachusetts just about everyone must have health insurance and insurers may not discriminate based on pre-existing conditions. Households making less than triple the Federal poverty rate get subsidized plans.) https://www.mahealthconnector.org/portal/site/connector/ https://www.mahealthconnector.org/portal/site/connector/

WalterBright 16y ago

Here's why it's broken. It's a long read, but worth it. The reasons are not what you'd expect, and not what you usually hear. http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/ http://www.theatlantic.com/magazine/archive/2009/09/how-amer...

zach 16y ago
You beat me to it! Fantastic article from a former startup CEO (I worked for him about 10 years ago). I thought I had heard all the arguments before I read it.

jasonkester 16y ago

to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. Actually, that's exactly the policy you want as a healthy 26 year old: $5,000 deductible catastrophic coverage, and nothing more. It'll cost you $86 per month from Blue Shield. Health insurance, in the sense that you see it in group policies from your employer, is not worth the cost if you're buying it yourself. It will be 15 years before you get to the point where a $50 copay and low deductible make sense. Think about it. How often are you at the doctor? Once a year? Once every 3 years? And it costs you a hundred bucks or so. That's not something you need to be insuring yourself against. The key is to keep a bit of insurance just in case you get in that car crash and need new hip joints, or if you suddenly develop bone cancer and are looking at $10k/month health care bills. Those things are crazy rare, and the policy that protects you against them is priced accordingly.

cookiecaper 16y ago
I guess you may be much healthier than the people I know, but I don't think I know very many people who go three years without a visit to the doctor. We all get infections that are considered minor and routine due to our medical care, but if we can't get that medical care they can be life-threatening, like strep throat or other common winter ailments. We all sometimes have accidents and trip and need to go to the hospital. There are lots of other things. Counting on visiting only once every three years is a bit dangerous imo.
- jasonkester 16y ago
  I remember exactly one doctor's visit in my 20s (bad dose of poison oak), one in my early 30s (bad bouldering fall), then nothing until age 39. So yeah, your mileage may vary. Needless to say, I never came close to hitting my $5k deductible. (or even my $250 annual deductible in the years when I had company-sponsored insurance).

thangalin 16y ago

In Canada, I pay $60.50 per month (was recently $57) into our Medical Services Plan: http://www.health.gov.bc.ca/msp/infoben/premium.html http://www.health.gov.bc.ca/msp/infoben/premium.html The West Coast, by the way, is beautiful. Vancouver BC and Seattle WA are practically sibling cities. Apply for citizenship. We'd love to have you!

steipete 16y ago

In austria, if you have your own business, you have to pay for the state own insurance company a part of your total income, which is usually a beween a few hundredths and thousand bucks PER MONTH. So don't argue with $50-$100 a month.

mbesto 16y ago

American expat in London here. Can't agree more. Healthy 26 year old with no conditions. I don't need NHS and don't mind pay taxes for it. I want to know it's there when I do need it though.

api 16y ago

What we have is everything that is bad about a private healthcare system combined with everything that is bad about socialized medicine. Over-regulation, high cost, and impossible to get without an employer or some other kind of large group. The American system benefits only one group: insurance companies.