4 ms·

In the US we pay hundreds of dollars in monthly medical premiums, thousands in deductibles per year, and still need to live in fear of surprise bankruptcy-level

In the US we pay hundreds of dollars in monthly medical premiums, thousands in deductibles per year, and still need to live in fear of surprise bankruptcy-level bills arriving if god forbid you collapse and need an emergency procedure at the closest out-of-network facility. Absolute insanity. Yet changing this at a fundamental level is somehow considered radical, nothing we can do etc., except what every other western country has already done. We keep telling ourselves we have the best medical care in the world, which anyone who has lived outside the US for some time can attest is complete bullshit.

wlesieutre 6y ago
Don't forget how much higher your car insurance is because if you get in an accident it needs to cover someone else's $200,000 medical bills
- deleted 6y ago
  [deleted]
koeng 6y ago
The entire pharma system is extremely complicated and there are a ton of weird incentives in its structure. Those incentive structures are really powerful, and since it is about human health, much harder to change. Good paper on the topic - https://link.springer.com/article/10.1057/biosoc.2010.40 https://link.springer.com/article/10.1057/biosoc.2010.40
HumblyTossed 6y ago
> ... and still need to live in fear of surprise bankruptcy-level bills arriving if god forbid you collapse and need an emergency procedure at the closest out-of-network facility. I don't know why this isn't illegal. You can go from living comfortably to living in poverty even though you held up your end of the contract except for that last time when you were not even conscious.
- berbec 6y ago
  Imagine this at mcdonalds: It'd like a burger OK, here it is. What is the charge? I'm not sure. I'll send you a bill in 2-32 weeks.
  - wlesieutre 6y ago
    I know someone dealing with this shenanigans right now, they sent two bills, which he paid, and then figured it was all sorted. Many months later, he finds out that they later sent two more bills to the address where he lived in middle school, never called him about it, and then referred them to debt collection because of course he hadn't paid them. He found out about this when the debts showed up on his credit monitoring. Now they're denying that he gave them his current address, despite the fact that he has multiple other bills with earlier dates where the hospital has printed the correct address on them. tldr: America's medical billing is an absurd shitshow
rayiner 6y ago
> Yet changing this at a fundamental level is somehow considered radical, nothing we can do etc., except what every other western country has already done. Except in the US wants to do what "every other western country has already done," which is to use payroll taxes on the middle class to subsidize mandatory health insurance or pay for a state-run system. Nobody in the US is actually serious about universal healthcare, except the folks who want to fix the ACA. Even Sanders promises not to raise taxes on people making below $250,000. If that's the promise, then all the other stuff is just talk, because the revenue can't be there to pay for any of it. Warren actually got close to a plan for accomplishing universal healthcare without raising middle class taxes, and it only proves what a complete farce that is. It features: - A wealth tax that goes up to 6%, four times higher than the 1.5% wealth taxes that Sweden and France abandoned (and most OECD countries never had) - Corporate taxes around 35-39%, higher than Sweden, France, Germany, Denmark, etc. - Capital gains taxed at the income rate, with a 70% top rate Each of those policies individually would be outside the mainstream of the OECD. But under Warren's plan, you'd need all of these in combination just to raise half the money needed for Medicare for All. So Sweden has corporate taxes around 22%, capital gains taxed at a flat 30%, and a top income tax rate of about 52% depending on municipality. It abandoned its wealth tax recently. Under Warren, the United States would have corporate taxes at 35% + the state rate (total 44% in California), a wealth tax going up to 6%, and a top marginal tax rate on capital gains of 70%. Obviously we'd never do that, which shows you how it was never a serious proposal.

wlesieutre 6y ago

Don't forget how much higher your car insurance is because if you get in an accident it needs to cover someone else's $200,000 medical bills

deleted 6y ago
[deleted]

koeng 6y ago

The entire pharma system is extremely complicated and there are a ton of weird incentives in its structure. Those incentive structures are really powerful, and since it is about human health, much harder to change. Good paper on the topic - https://link.springer.com/article/10.1057/biosoc.2010.40 https://link.springer.com/article/10.1057/biosoc.2010.40

HumblyTossed 6y ago

> ... and still need to live in fear of surprise bankruptcy-level bills arriving if god forbid you collapse and need an emergency procedure at the closest out-of-network facility. I don't know why this isn't illegal. You can go from living comfortably to living in poverty even though you held up your end of the contract except for that last time when you were not even conscious.

berbec 6y ago
Imagine this at mcdonalds: It'd like a burger OK, here it is. What is the charge? I'm not sure. I'll send you a bill in 2-32 weeks.
- wlesieutre 6y ago
  I know someone dealing with this shenanigans right now, they sent two bills, which he paid, and then figured it was all sorted. Many months later, he finds out that they later sent two more bills to the address where he lived in middle school, never called him about it, and then referred them to debt collection because of course he hadn't paid them. He found out about this when the debts showed up on his credit monitoring. Now they're denying that he gave them his current address, despite the fact that he has multiple other bills with earlier dates where the hospital has printed the correct address on them. tldr: America's medical billing is an absurd shitshow

rayiner 6y ago

> Yet changing this at a fundamental level is somehow considered radical, nothing we can do etc., except what every other western country has already done. Except in the US wants to do what "every other western country has already done," which is to use payroll taxes on the middle class to subsidize mandatory health insurance or pay for a state-run system. Nobody in the US is actually serious about universal healthcare, except the folks who want to fix the ACA. Even Sanders promises not to raise taxes on people making below $250,000. If that's the promise, then all the other stuff is just talk, because the revenue can't be there to pay for any of it. Warren actually got close to a plan for accomplishing universal healthcare without raising middle class taxes, and it only proves what a complete farce that is. It features: - A wealth tax that goes up to 6%, four times higher than the 1.5% wealth taxes that Sweden and France abandoned (and most OECD countries never had) - Corporate taxes around 35-39%, higher than Sweden, France, Germany, Denmark, etc. - Capital gains taxed at the income rate, with a 70% top rate Each of those policies individually would be outside the mainstream of the OECD. But under Warren's plan, you'd need all of these in combination just to raise half the money needed for Medicare for All. So Sweden has corporate taxes around 22%, capital gains taxed at a flat 30%, and a top income tax rate of about 52% depending on municipality. It abandoned its wealth tax recently. Under Warren, the United States would have corporate taxes at 35% + the state rate (total 44% in California), a wealth tax going up to 6%, and a top marginal tax rate on capital gains of 70%. Obviously we'd never do that, which shows you how it was never a serious proposal.