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And someone not living in Berlin can live significantly cheaper too - do you want to pick a city similar to Des Moines in Germany? EDIT: I took your number of

And someone not living in Berlin can live significantly cheaper too - do you want to pick a city similar to Des Moines in Germany? EDIT: I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. Then, after running the numbers for a high-tech worker, do you want to run the numbers for your janitor? The definition of "health insurance" in the US is weird - it doesn't actually seem to mean you're going to be able to be able to access either expected or unexpected healthcare needs at a price you can afford.

rayiner 6y ago
> I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. That's probably quite accurate. But most people don't have a $60,000 unexpected health expenditure before they're eligible for Medicare at 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/ > We calculated this estimate as follows: the graph shows that, on average, a hospitalization increases the annual probability of going bankrupt in the following 4 years by 0.004. Multiplying this figure by the annual hospitalization rate of 7.8% for our population (which we calculated using the 1999–2010 Medical Expenditure Panel Survey) reveals that 0.031% (0.004 × 7.8%) of the population goes bankrupt each year as the result of a hospitalization. If you extrapolate this out over the 40-year period covered in the study (it covers people ages 25-65) there is just a 1.2% chance that you'll go bankrupt as a result of medical debt in your working lifetime. In a country of 205 million working-age adults, that amounts to 2-3 million people. That's why you see so many news stories about it. But the odds of it actually happening to you are fairly low. Meanwhile, the higher taxes from universal healthcare are something that affect 100% of people. If you ask people "would you rather make $5,000 more per year, or have a 1.2% chance that sometime in your working life, you'll have to declare bankruptcy due to exorbitant medical bills?" You can't say it's an irrational choice if people choose to have more money in their pocket now. > The definition of "health insurance" in the US is weird - it doesn't actually seem to mean you're going to be able to be able to access either expected or unexpected healthcare needs at a price you can afford. And what are you basing this on? I've got a wife and two kids. We've need to rely on our health insurance for everything from a car accident that almost resulted in a pre-term birth, to child births. The system is chaotic and confusing, but as long as you're on top of the paperwork the coverage is usually very good. According to Gallup polling, people have negative views of the healthcare system as a whole, but most rate their own coverage as good or excellent (69%) and their own healthcare service quality as good or excellent (80%): https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx https://news.gallup.com/poll/245195/americans-rate-healthcar....
- ido 6y ago
  I'm sure that as you say it works out for most people on a purely rational game-theory economic sense but I would definitely chose 100% coverage over an extra $5k/year. The whole system (not just health care) seems so stressful and antagonistic in the US. If I had an extra $5k/year I'd probably just spend it on meaningless consumption like a bigger TV or a better car, where as not having to give a second thought about costs for medical care or higher education for my kids gives me so much more peace of mind. Also keep in mind that not everybody has their proverbial shit together. You have to be resilient and make a lot of right life choices or you can fall into a pretty deep hole. The "paternalistic" approach of welfare states like in central & northern Europe means that as long as you basically "follow the rules" (like not breaking the law & having/keeping just about any job/career, even working-class ones) you're going to have a decent life, at least materially.
  - rayiner 6y ago
    > If I had an extra $5k/year I'd probably just spend it on meaningless consumption like a bigger TV or a better car, where as not having to give a second thought about costs for medical care or higher education for my kids gives me so much more peace of mind. We do. The median house in the US is twice as big as in Germany or France. We have 50% more cars per person than Germany and almost twice as many as France. Even excluding healthcare (to exclude the effect of inflated healthcare costs in the US), per person household consumption spending is 50% higher in the US than France, based on OECD data.
    - ido 6y ago
      I'm not sure if this means you agree with me or disagree? America is a staggeringly wealthy country and yet you spend all that wealth on trinkets while saying you can't afford universal healthcare, free education, fewer working hours, more vacation days, paid parental leave & other social benefits almost every other developed country provides their citizens.
- vertex-four 6y ago
  > And what are you basing this on? Talking to working-class friends in the US about their access to healthcare. They feel concerned about the price of going to their doctor about things that our doctors urge us to talk to them about. Routine, expected medical treatment often takes years of saving up, and I've had friends die before they managed to get that treatment. When people wind up with an illness requiring ongoing treatment, any additional money they might make quickly goes down the drain. They also feel scared about losing their job, and therefore their access to healthcare, if they ever become ill enough to have to call off sick, thus compounding the problem. Yes, it's rational when you're well-off to want to keep your money. But I'd very much prefer to make sure the people around me have real access to healthcare than that I can maybe buy a slightly nicer house.

rayiner 6y ago

> I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. That's probably quite accurate. But most people don't have a $60,000 unexpected health expenditure before they're eligible for Medicare at 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/ > We calculated this estimate as follows: the graph shows that, on average, a hospitalization increases the annual probability of going bankrupt in the following 4 years by 0.004. Multiplying this figure by the annual hospitalization rate of 7.8% for our population (which we calculated using the 1999–2010 Medical Expenditure Panel Survey) reveals that 0.031% (0.004 × 7.8%) of the population goes bankrupt each year as the result of a hospitalization. If you extrapolate this out over the 40-year period covered in the study (it covers people ages 25-65) there is just a 1.2% chance that you'll go bankrupt as a result of medical debt in your working lifetime. In a country of 205 million working-age adults, that amounts to 2-3 million people. That's why you see so many news stories about it. But the odds of it actually happening to you are fairly low. Meanwhile, the higher taxes from universal healthcare are something that affect 100% of people. If you ask people "would you rather make $5,000 more per year, or have a 1.2% chance that sometime in your working life, you'll have to declare bankruptcy due to exorbitant medical bills?" You can't say it's an irrational choice if people choose to have more money in their pocket now. > The definition of "health insurance" in the US is weird - it doesn't actually seem to mean you're going to be able to be able to access either expected or unexpected healthcare needs at a price you can afford. And what are you basing this on? I've got a wife and two kids. We've need to rely on our health insurance for everything from a car accident that almost resulted in a pre-term birth, to child births. The system is chaotic and confusing, but as long as you're on top of the paperwork the coverage is usually very good. According to Gallup polling, people have negative views of the healthcare system as a whole, but most rate their own coverage as good or excellent (69%) and their own healthcare service quality as good or excellent (80%): https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx https://news.gallup.com/poll/245195/americans-rate-healthcar....

ido 6y ago
I'm sure that as you say it works out for most people on a purely rational game-theory economic sense but I would definitely chose 100% coverage over an extra $5k/year. The whole system (not just health care) seems so stressful and antagonistic in the US. If I had an extra $5k/year I'd probably just spend it on meaningless consumption like a bigger TV or a better car, where as not having to give a second thought about costs for medical care or higher education for my kids gives me so much more peace of mind. Also keep in mind that not everybody has their proverbial shit together. You have to be resilient and make a lot of right life choices or you can fall into a pretty deep hole. The "paternalistic" approach of welfare states like in central & northern Europe means that as long as you basically "follow the rules" (like not breaking the law & having/keeping just about any job/career, even working-class ones) you're going to have a decent life, at least materially.
- rayiner 6y ago
  > If I had an extra $5k/year I'd probably just spend it on meaningless consumption like a bigger TV or a better car, where as not having to give a second thought about costs for medical care or higher education for my kids gives me so much more peace of mind. We do. The median house in the US is twice as big as in Germany or France. We have 50% more cars per person than Germany and almost twice as many as France. Even excluding healthcare (to exclude the effect of inflated healthcare costs in the US), per person household consumption spending is 50% higher in the US than France, based on OECD data.
  - ido 6y ago
    I'm not sure if this means you agree with me or disagree? America is a staggeringly wealthy country and yet you spend all that wealth on trinkets while saying you can't afford universal healthcare, free education, fewer working hours, more vacation days, paid parental leave & other social benefits almost every other developed country provides their citizens.
vertex-four 6y ago
> And what are you basing this on? Talking to working-class friends in the US about their access to healthcare. They feel concerned about the price of going to their doctor about things that our doctors urge us to talk to them about. Routine, expected medical treatment often takes years of saving up, and I've had friends die before they managed to get that treatment. When people wind up with an illness requiring ongoing treatment, any additional money they might make quickly goes down the drain. They also feel scared about losing their job, and therefore their access to healthcare, if they ever become ill enough to have to call off sick, thus compounding the problem. Yes, it's rational when you're well-off to want to keep your money. But I'd very much prefer to make sure the people around me have real access to healthcare than that I can maybe buy a slightly nicer house.