7 ms·

For healthcare, you can probably segment America a little more generously into insured vs uninsured. If you are insured in America, your healthcare is reasonabl

For healthcare, you can probably segment America a little more generously into insured vs uninsured. If you are insured in America, your healthcare is reasonably good. Lower quality plans may have more restrictive networks or higher deductibles and maximums, but these are manageable and neither are truly barriers to care.

bryan11 6y ago
You could segment them in three sets: well insured, people with catastrophic health plans, and uninsured. Many employers are switching to high deductible health plans and that deductible may be thousands of dollars, i.e. catastrophic plans. When going to a doctor for a simple diagnosis or bloodwork can easily cost $400 to $1000, many put off doctor visits unless it's an emergency. It can easily become a choice between a doctor visit or a car repair. Preventative checkups are gone and insurance is only something one uses with an emergency room visit or major health issue.
- TuringNYC 6y ago
  That's a great explanation. It also shows how short-sighted such plans us at a national macro level -- because an ounce of prevention can prevent hundreds of thousands in future future bills. A perfect example is vitamin deficiency and the very serious effects such deficiencies can have, and how inexpensive the preventative care is.
  - kube-system 6y ago
    It is getting better. The ACA mandates coverage for some preventative care.
- Thorentis 6y ago
  $400 for just a bloodtest at a GP? That's insane. All free in Australia, from the initial visit, to the blood taking, to the follow up.
  - freeone3000 6y ago
    This isn't inflated, really -- Quebec doctors are allowed to charge about the same to the province (depending on several factors, but it's within 2x even for the cheapest option), so it's a reasonable approximation of the costs involved, it's just who pays for it and when.
  - dragonsky 6y ago
    Maybe a more accurate description of Australia is that it can be free, but you may have to wait for a dr appointment. Or you can go to one of the non bulk-billing doctors and a nice lounge to sit on whilst you wait. Generally necessary pathology/radiology or routine blood tests are covered by medicare which is paid for by a levy of about 1% on income. Likewise pharmaceuticals are generally fairly low cost (there are exceptions), being subsidised by the government and for low income or people with ongoing requirements can be free. Private health insurance is available and encouraged by a decrease in your medicare levy, but a lot of people are finding that it doesn't provide any financial benefit and as we have a very good public health system, does not provide any better health outcome. Health Insurance is not a major concern in Australia. It certainly is not tied to an employer and doesn't rate on the list of things to worry about when getting a job.
- bluGill 6y ago
  I have long been against employer provided health insurance. Obama promised if you like your insurance you can keep it. He was mostly correct (if you squint just right there are some minor changes to everyone's plan which you can count as not keeping it), but I don't like my health insurance - but to get a different plan means throwing away the large subsidy I get from my employer to take their plan.
JohnTHaller 6y ago
Even if you're insured in the US, you often can't afford care anymore. My private insurance plan costs $6,000 a year and has a $5,000 deductible. It was very bad pre-ACA. I paid over $8,000 a year on the private market and never let it lapse so my kidney donation wouldn't become pre-existing. Under the ACA it dropped a ton. But it's gotten much worse over the past years as it was weakened.
MeinBlutIstBlau 6y ago
I would rather be uninsured and take my chances than work a low waged job and pay for Obamacare. $500/month for a single person, highest deductible plan is ludicrous. Thats fucking 80-90% rent for many people where I live...if not 100%+.
- danans 6y ago
  > I would rather be uninsured and take my chances So you won't seek medical treatment at a hospital if you get injured or become severely ill? Or do you plan to go to the hospital and pay out of pocket? Or, like some other voluntarily uninsured people, will you ask for medical treatment and then just not pay? > than work a low waged job and pay for Obamacare. Why would a "low waged" job be a requirement, unless that's the only job you can get? You can pay for Obamacare with a middle or high wage job too. You can also pay for it if you are self employed (which is a lot of people on Obamacare).
  - im3w1l 6y ago
    I think he is saying that for many people it's just too much money. And that if they would be denied care, then so be it. This is where it gets uncomfortable, isn't it? That their lives are so miserable, that they would gladly trade away years and years of expected lifespan for higher quality of life.
    - kube-system 6y ago
      It’s illegal to turn anyone down in the ER for their ability to pay (at most hospitals). If you show up with an emergency, you will get treated, and the bill comes afterwards. Now, you’re definitely not going to get a luxury treatment, but they will patch you up so you’re not dying. https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_... It isn’t the way we should want this to work, but it is certainly something that people actually do.
      - StanislavPetrov 6y ago
rweir 6y ago
I disagree, a combination of cost of health care even for insured people, enormous worst case out of pocket costs and terrible wages means that people are conditioned to not go to the doctor (and conversely that some people are conditioned to go to the doctor to get "use" of their insurance) even when they are "insured".

bryan11 6y ago

You could segment them in three sets: well insured, people with catastrophic health plans, and uninsured. Many employers are switching to high deductible health plans and that deductible may be thousands of dollars, i.e. catastrophic plans. When going to a doctor for a simple diagnosis or bloodwork can easily cost $400 to $1000, many put off doctor visits unless it's an emergency. It can easily become a choice between a doctor visit or a car repair. Preventative checkups are gone and insurance is only something one uses with an emergency room visit or major health issue.

TuringNYC 6y ago
That's a great explanation. It also shows how short-sighted such plans us at a national macro level -- because an ounce of prevention can prevent hundreds of thousands in future future bills. A perfect example is vitamin deficiency and the very serious effects such deficiencies can have, and how inexpensive the preventative care is.
- kube-system 6y ago
  It is getting better. The ACA mandates coverage for some preventative care.
Thorentis 6y ago
$400 for just a bloodtest at a GP? That's insane. All free in Australia, from the initial visit, to the blood taking, to the follow up.
- freeone3000 6y ago
  This isn't inflated, really -- Quebec doctors are allowed to charge about the same to the province (depending on several factors, but it's within 2x even for the cheapest option), so it's a reasonable approximation of the costs involved, it's just who pays for it and when.
- dragonsky 6y ago
  Maybe a more accurate description of Australia is that it can be free, but you may have to wait for a dr appointment. Or you can go to one of the non bulk-billing doctors and a nice lounge to sit on whilst you wait. Generally necessary pathology/radiology or routine blood tests are covered by medicare which is paid for by a levy of about 1% on income. Likewise pharmaceuticals are generally fairly low cost (there are exceptions), being subsidised by the government and for low income or people with ongoing requirements can be free. Private health insurance is available and encouraged by a decrease in your medicare levy, but a lot of people are finding that it doesn't provide any financial benefit and as we have a very good public health system, does not provide any better health outcome. Health Insurance is not a major concern in Australia. It certainly is not tied to an employer and doesn't rate on the list of things to worry about when getting a job.
bluGill 6y ago
I have long been against employer provided health insurance. Obama promised if you like your insurance you can keep it. He was mostly correct (if you squint just right there are some minor changes to everyone's plan which you can count as not keeping it), but I don't like my health insurance - but to get a different plan means throwing away the large subsidy I get from my employer to take their plan.

JohnTHaller 6y ago

Even if you're insured in the US, you often can't afford care anymore. My private insurance plan costs $6,000 a year and has a $5,000 deductible. It was very bad pre-ACA. I paid over $8,000 a year on the private market and never let it lapse so my kidney donation wouldn't become pre-existing. Under the ACA it dropped a ton. But it's gotten much worse over the past years as it was weakened.

MeinBlutIstBlau 6y ago

I would rather be uninsured and take my chances than work a low waged job and pay for Obamacare. $500/month for a single person, highest deductible plan is ludicrous. Thats fucking 80-90% rent for many people where I live...if not 100%+.

danans 6y ago
> I would rather be uninsured and take my chances So you won't seek medical treatment at a hospital if you get injured or become severely ill? Or do you plan to go to the hospital and pay out of pocket? Or, like some other voluntarily uninsured people, will you ask for medical treatment and then just not pay? > than work a low waged job and pay for Obamacare. Why would a "low waged" job be a requirement, unless that's the only job you can get? You can pay for Obamacare with a middle or high wage job too. You can also pay for it if you are self employed (which is a lot of people on Obamacare).
- im3w1l 6y ago
  I think he is saying that for many people it's just too much money. And that if they would be denied care, then so be it. This is where it gets uncomfortable, isn't it? That their lives are so miserable, that they would gladly trade away years and years of expected lifespan for higher quality of life.
  - kube-system 6y ago
    It’s illegal to turn anyone down in the ER for their ability to pay (at most hospitals). If you show up with an emergency, you will get treated, and the bill comes afterwards. Now, you’re definitely not going to get a luxury treatment, but they will patch you up so you’re not dying. https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_... It isn’t the way we should want this to work, but it is certainly something that people actually do.
    - StanislavPetrov 6y ago

rweir 6y ago

I disagree, a combination of cost of health care even for insured people, enormous worst case out of pocket costs and terrible wages means that people are conditioned to not go to the doctor (and conversely that some people are conditioned to go to the doctor to get "use" of their insurance) even when they are "insured".