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If you are focused on the U.S., then I understand your sentiment. But if you look beyond, it is really promising. Medical science and biology are producing new

If you are focused on the U.S., then I understand your sentiment. But if you look beyond, it is really promising. Medical science and biology are producing new scientific knowledge about CoViD-19 and SARS-Cov2 at break neck speed. That alone is amazing to see. On the other hand, you really see that people get it and that they have to do social distancing to help them and everybody else. On top of that you see, e.g. China helping European countries in their crisis. That is unprecedented. The outlook for the U.S. might be more grim, at least as seen from Europe. It seems pretty obvious that medicine as a business is not the right setup to tackle a pandemic. Germany moved into that direction into the last 20 years. And everybody is realizing the downsides of that move, now. Although it could be seen for 20 years if you bothered to look. Back to the U.S., I find it deeply worrying that people started to buy guns. Do they believe they could shoot the virus? Or do they expect looting and civil uproar? That would be the worst people could do in such a crisis. I hope it doesn't come to that. And finally, Trump. I think I don't have to write anything about him by now.

gingerlime 7y ago
I know it’s OT but would love to understand more about the health insurance situation in Germany and what’s happened in the last 20 years. Ideally in English which is a big ask I guess. Moved to Germany in 2011 and still can’t work out the whole insurance thing (and don’t understand German enough to read and figure those nuances)
- funcDropShadow 7y ago
  To make it short, 20 years ago most hospitals were privatized, before they were run by universities, cities, and states and some other public actors. There were already some private hospitals, but not too much. Since, then most hospitals were sold to companies or in the better case transformed into companies, partly owned by their previous owner. Companies optimize for revenue, so they don't spend money on stocks of masks or reserve capacities that are only needed once in a lifetime. Nevertheless, there are significantly more ICU beds per capita in Germany than in most other european or western countries. The insurance system is split in two almost separate systems. One for everybody, the public health insurance system, where you can choose and switch between a range of public insurers. You must have health insurance in Germany. E.g. you cannot spend a semester as an exchange student without health insurance. If you earn above a certain amount per year, you are assumed to be able to provide for your own health insurance. You can opt-out of public health insurance and get a private one. They are very competitevly priced for young and healthy individuals. And they usually have way wider coverage. But you cannot go back after a certain age. So it is a risk, and there have been insurers that raised the cost of private insurance for elderly people by multiple hundred percents. On the other hand, the cost of public health insurances depends on your income and not on your health. If you are unemployed and you show that you try to get a job, your public health insurance is free as well. And children are free, if both their parents are in public health insurance. Then, there are private insurance policies that add on top of public health insurance coverage. Most people are in the public health insurance system in Germany.
  - lnsru 7y ago
    I have public health insurance, but if you need some better treatment you can always pay for it by yourself. Some minor surgery for 300€ isn’t big deal. Or one can get additional insurance packages to mandatory insurance for all the special needs. My all older colleagues tell me, that private insurance is kind of scam. You pay almost nothing when you are young, but with age it costs more and more. You pay for kids on top and barely get better treatment than regular insured.
    - maigret 7y ago
      An insurance lawyer (friend of mine) also advised me to stay on a public plan and add up private addons where needed - those can be canceled very easily. I’ve not regretted that decision since.
      - gingerlime 7y ago
        I’d love to talk to you or your friend if you don’t mind. My contact details are on my HN profile.
    - gingerlime 7y ago
      Probably not better treatment but my private insurance almost always gets me faster appointments. I just mention the magic word and suddenly there’s an available slot next week (otherwise only in a few months). Happened more than once. My insurance broker said that the price I pay now should cover future payments and increases are only allowed if there are some overall increases to the treatment options. ie new more expensive treatments become available... so cost can increase but within certain boundaries. Was I misguided on that one?
  - photonios 7y ago
    I think the Dutch system gives you the best of both worlds. Everyone is required to have at least basic health insurance. Every year, there's a new definition of what "basic insurance" entails and all insurance providers are required provide a "basic insurance" package at a specific cost. Of course, there are all sorts of addons to increase your coverage. If you are unemployed or earn below a certain treshold, you get a monthly stipend to pay for basic insurance. In the end, I can choose where to get my insurance from, but "basic insurance" is the same price everywhere and if I lose my job or I have very little income, I am guarenteed to get that stipend to help pay for it. Basic insurance is roughly ~100 euros/month.
- hef19898 7y ago
  As others stated, you have the public and the private system. The latter is accessible after you earn above a certain threshold for a certain number of years (no idea about the specifics as I would have been eligible but never bothered to change). You also have niche solutions for certain free professionals (doctors, artists,...). I would call the system pretty robust, as you cannot be uninsured. From personal experience: Having my kids insured under my name, under my wife's name when I earned less than her, being insured under my wife during a certain time of a sabbatical, insured through unemployment and now as an entrepreneur I never changed insurance provider. Only the status changed. Interesting detail, even the public health insurance sector is run by commercial insurance companies. The minimum plans are defined by the state. Regardless of how many people are insured under your name, premiums don't change and stay at a certain percentage of your salary. Again, slight differences between providers but usually around 15 or so percent. Currently I pay much less, as there is no revenue yet. Also nice, premiums don't change with previous sickness and preexisting conditions. Also 6 weeks of paid sick leave per sickness, resets for each sickness after a certain number of months (again, don't ask the exact number). One important insurance to add is continued salary after the six weeks are over. Costs close to nothing when done early and can save you. Non serious things tend to be over well within 6 weeks. But serious ones can take considerably longer. And the last thing you want is money problems the. I spend 6 months on sick leave once, didn't have to worry about my job nor money. Was a nice thing.
thrav 7y ago
Unemployment in the United States is not like unemployment anywhere else in the world. This situation is exposing all of the gaping holes in the American system. Mass layoffs already, leading to mass loss of health insurance, and bills for COVID treatment already surfacing in the many thousands of dollars. If people start to have trouble putting food on the table, shit could get ugly real fast.
- sokoloff 7y ago
  Though the employer-tied insurance issue is a problem generally, it’s somewhat less dire for the situation you describe above because of COBRA. (Especially less dire for the first 60 days, because you can retroactively opt-in for some period.) https://www.healthcare.gov/unemployed/cobra-coverage/ https://www.healthcare.gov/unemployed/cobra-coverage/
  - tyingq 7y ago
    Have you seen COBRA prices? You could easily go from $400/month (group rate + employer subsidized) to $2k+ for a good plan that covers a family.
  - dillonmckay 7y ago
    No. If I were laid-off, I would receive a maximum of $1600/mo from unemployment in my state for 6 months. So, the trade-off is either COBRA or mortgage payment. I doubt the US medical system will get better in the short term.
  - deleted 7y ago
    [deleted]
cossray 7y ago
As someone outside of the US, news about people of the City of Corona queuing to buy guns was quite shocking. Things are difficult everywhere but a rush to buy guns, not least in the most powerful country, is probably one of the most shocking of all the responses I have read and seen so far. I hope none of those guns will need to be used. The virus is already enough of an enemy
- HeadsUpHigh 7y ago
  Eh calm down people always buy guns and ammo on every crisis that happens, even after every elections. It's nothing new.
- JoeAltmaier 7y ago
  Strangely there can be a calming effect, with many people armed. Believe it or not, unscrupulous folk may hesitate to act in times of shortage if their neighbors are armed.
  - monadic2 7y ago
    I’d be much more worried they’d be carrying out the looting if layoffs continue with no relief.
    - JoeAltmaier 7y ago
      Again, that'd be short-lived. Literally.
stevespang 7y ago
"It seems pretty obvious that medicine as a business is not the right setup to tackle a pandemic" . . Hospitals have already put a virtual "lock" on the supply chain of chloroquine and hydroxychloroquine to make sure they get the bulk of it and you have to come to them to get the drugs . . they are sharpening their teeth and their billing offices are humming. I bought my chloroquine before all the independent pharmacies got raided, with medicare and suppl. insurance it cost me 70 cents for the entire prescription - - what do you think hospitals will be billing for that same 'script ? From what billing gouging examples that are posted on the 'net likely $700.00 "I find it deeply worrying that people started to buy guns" . . . Look at history, what do you expect when you have 20% or more of the lowest tier of the working population laid off for months or more (60 million people) . . . crime will definitely increase and there won't be adequate police to control it. It could get real bad - - real fast. Only liberal Dems want to take away all our guns and then risk our families to be raped, robbed and plundered . . . buying guns and ammo and 99% a defensive, preparatory, and protective reaction - - not offensive. It is completely within the rights of Americans to protect their families and their property from criminals.

gingerlime 7y ago

I know it’s OT but would love to understand more about the health insurance situation in Germany and what’s happened in the last 20 years. Ideally in English which is a big ask I guess. Moved to Germany in 2011 and still can’t work out the whole insurance thing (and don’t understand German enough to read and figure those nuances)

funcDropShadow 7y ago
To make it short, 20 years ago most hospitals were privatized, before they were run by universities, cities, and states and some other public actors. There were already some private hospitals, but not too much. Since, then most hospitals were sold to companies or in the better case transformed into companies, partly owned by their previous owner. Companies optimize for revenue, so they don't spend money on stocks of masks or reserve capacities that are only needed once in a lifetime. Nevertheless, there are significantly more ICU beds per capita in Germany than in most other european or western countries. The insurance system is split in two almost separate systems. One for everybody, the public health insurance system, where you can choose and switch between a range of public insurers. You must have health insurance in Germany. E.g. you cannot spend a semester as an exchange student without health insurance. If you earn above a certain amount per year, you are assumed to be able to provide for your own health insurance. You can opt-out of public health insurance and get a private one. They are very competitevly priced for young and healthy individuals. And they usually have way wider coverage. But you cannot go back after a certain age. So it is a risk, and there have been insurers that raised the cost of private insurance for elderly people by multiple hundred percents. On the other hand, the cost of public health insurances depends on your income and not on your health. If you are unemployed and you show that you try to get a job, your public health insurance is free as well. And children are free, if both their parents are in public health insurance. Then, there are private insurance policies that add on top of public health insurance coverage. Most people are in the public health insurance system in Germany.
- lnsru 7y ago
  I have public health insurance, but if you need some better treatment you can always pay for it by yourself. Some minor surgery for 300€ isn’t big deal. Or one can get additional insurance packages to mandatory insurance for all the special needs. My all older colleagues tell me, that private insurance is kind of scam. You pay almost nothing when you are young, but with age it costs more and more. You pay for kids on top and barely get better treatment than regular insured.
  - maigret 7y ago
    An insurance lawyer (friend of mine) also advised me to stay on a public plan and add up private addons where needed - those can be canceled very easily. I’ve not regretted that decision since.
    - gingerlime 7y ago
      I’d love to talk to you or your friend if you don’t mind. My contact details are on my HN profile.
  - gingerlime 7y ago
    Probably not better treatment but my private insurance almost always gets me faster appointments. I just mention the magic word and suddenly there’s an available slot next week (otherwise only in a few months). Happened more than once. My insurance broker said that the price I pay now should cover future payments and increases are only allowed if there are some overall increases to the treatment options. ie new more expensive treatments become available... so cost can increase but within certain boundaries. Was I misguided on that one?
- photonios 7y ago
  I think the Dutch system gives you the best of both worlds. Everyone is required to have at least basic health insurance. Every year, there's a new definition of what "basic insurance" entails and all insurance providers are required provide a "basic insurance" package at a specific cost. Of course, there are all sorts of addons to increase your coverage. If you are unemployed or earn below a certain treshold, you get a monthly stipend to pay for basic insurance. In the end, I can choose where to get my insurance from, but "basic insurance" is the same price everywhere and if I lose my job or I have very little income, I am guarenteed to get that stipend to help pay for it. Basic insurance is roughly ~100 euros/month.
hef19898 7y ago
As others stated, you have the public and the private system. The latter is accessible after you earn above a certain threshold for a certain number of years (no idea about the specifics as I would have been eligible but never bothered to change). You also have niche solutions for certain free professionals (doctors, artists,...). I would call the system pretty robust, as you cannot be uninsured. From personal experience: Having my kids insured under my name, under my wife's name when I earned less than her, being insured under my wife during a certain time of a sabbatical, insured through unemployment and now as an entrepreneur I never changed insurance provider. Only the status changed. Interesting detail, even the public health insurance sector is run by commercial insurance companies. The minimum plans are defined by the state. Regardless of how many people are insured under your name, premiums don't change and stay at a certain percentage of your salary. Again, slight differences between providers but usually around 15 or so percent. Currently I pay much less, as there is no revenue yet. Also nice, premiums don't change with previous sickness and preexisting conditions. Also 6 weeks of paid sick leave per sickness, resets for each sickness after a certain number of months (again, don't ask the exact number). One important insurance to add is continued salary after the six weeks are over. Costs close to nothing when done early and can save you. Non serious things tend to be over well within 6 weeks. But serious ones can take considerably longer. And the last thing you want is money problems the. I spend 6 months on sick leave once, didn't have to worry about my job nor money. Was a nice thing.

thrav 7y ago

Unemployment in the United States is not like unemployment anywhere else in the world. This situation is exposing all of the gaping holes in the American system. Mass layoffs already, leading to mass loss of health insurance, and bills for COVID treatment already surfacing in the many thousands of dollars. If people start to have trouble putting food on the table, shit could get ugly real fast.

sokoloff 7y ago
Though the employer-tied insurance issue is a problem generally, it’s somewhat less dire for the situation you describe above because of COBRA. (Especially less dire for the first 60 days, because you can retroactively opt-in for some period.) https://www.healthcare.gov/unemployed/cobra-coverage/ https://www.healthcare.gov/unemployed/cobra-coverage/
- tyingq 7y ago
  Have you seen COBRA prices? You could easily go from $400/month (group rate + employer subsidized) to $2k+ for a good plan that covers a family.
- dillonmckay 7y ago
  No. If I were laid-off, I would receive a maximum of $1600/mo from unemployment in my state for 6 months. So, the trade-off is either COBRA or mortgage payment. I doubt the US medical system will get better in the short term.
- deleted 7y ago
  [deleted]

cossray 7y ago

As someone outside of the US, news about people of the City of Corona queuing to buy guns was quite shocking. Things are difficult everywhere but a rush to buy guns, not least in the most powerful country, is probably one of the most shocking of all the responses I have read and seen so far. I hope none of those guns will need to be used. The virus is already enough of an enemy

HeadsUpHigh 7y ago
Eh calm down people always buy guns and ammo on every crisis that happens, even after every elections. It's nothing new.
JoeAltmaier 7y ago
Strangely there can be a calming effect, with many people armed. Believe it or not, unscrupulous folk may hesitate to act in times of shortage if their neighbors are armed.
- monadic2 7y ago
  I’d be much more worried they’d be carrying out the looting if layoffs continue with no relief.
  - JoeAltmaier 7y ago
    Again, that'd be short-lived. Literally.

stevespang 7y ago

"It seems pretty obvious that medicine as a business is not the right setup to tackle a pandemic" . . Hospitals have already put a virtual "lock" on the supply chain of chloroquine and hydroxychloroquine to make sure they get the bulk of it and you have to come to them to get the drugs . . they are sharpening their teeth and their billing offices are humming. I bought my chloroquine before all the independent pharmacies got raided, with medicare and suppl. insurance it cost me 70 cents for the entire prescription - - what do you think hospitals will be billing for that same 'script ? From what billing gouging examples that are posted on the 'net likely $700.00 "I find it deeply worrying that people started to buy guns" . . . Look at history, what do you expect when you have 20% or more of the lowest tier of the working population laid off for months or more (60 million people) . . . crime will definitely increase and there won't be adequate police to control it. It could get real bad - - real fast. Only liberal Dems want to take away all our guns and then risk our families to be raped, robbed and plundered . . . buying guns and ammo and 99% a defensive, preparatory, and protective reaction - - not offensive. It is completely within the rights of Americans to protect their families and their property from criminals.