5 ms·

Health insurance is not the same as universally free health care at the point of service / request for every citizen.

rayiner 6y ago
Most countries with “universal healthcare” actually have some sort of “universal health insurance.” And it’s usually not free at the point of service. Finland for example has a user fees and co-pays at the point of service.
- jahaja 6y ago
  I think it's pretty relevant to post how large these Finnish fees and co-pays are compared to the US? It comes across as pretty dishonest to omit that the fee is almost symbolic in comparison. In Sweden it's like 200SEK (~$20) per visit and it seems to be 20 euro in Finland. And both fees have a cap for people needing a lot of care.
  - tptacek 6y ago
    The average US insurance copay for a doctor's office visit is, wait for it, $20. Retail health care is not where the expense insanity in the US system kicks in.
    - jahaja 6y ago
      What's your point? This is more or less the end of the road in Sweden and Finland with regards to fees/co-pays, there's no difference with regards to severity. Not sure why you guys are so eager to try a "it's actually pretty much the same as here" when it clearly requires an extremely superficial look.
      - tptacek 6y ago
        I don't know who "you guys are"; I'm a liberal Democrat and Rayiner is not. I'm just saying that in the retail health care setting we always seem to be talking about, the cost-sharing expectations of Europe are quite comparable to those of insured people in the US. This is a problem for people whose argument about the failings of US health care condenses to "insurance isn't enough". The US health care system has deep, systemic problems! It's just probably not the copay problem.
        jahaja 6y ago
        > I'm a liberal Democrat and Rayiner is not. Well, if so, your seemingly minor differences judging from the threads you both participate in here on HN seems pretty much symptomatic for US politics to me. Two parties, both business parties, and minor differences in their realpolitik. > It's just probably not the copay problem I'm regularly hearing stories about people having to pay hundreds or thousands of dollars for procedures, even chronic things like insulin.
      - rayiner 6y ago
        You don’t have to speculate about this stuff. The OECD tracks out of pocket healthcare spending: https://www.oecd.org/health/health-systems/OECD-Focus-on-Out-of-Pocket-Spending-April-2019.pdf https://www.oecd.org/health/health-systems/OECD-Focus-on-Out... It’s a couple of hundred dollars a year more than Finland or Sweden, but nothing dramatic. And the fees/co-pays are of course not the end of the road. People in Sweden and Finland pay a lot more taxes. They pay thousands of dollars more every year, even when they don’t get sick. Median after-tax disposable income, according to the OECD, is $14,000-16,000/year more in the US than Finland or Sweden. Now, of course, Americans spend a significant part of that difference on deductibles, premiums, etc. But in most states it’s a few thousand dollars a year on average. https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket https://www.commonwealthfund.org/publications/issue-briefs/2...
        jahaja 6y ago
        > It’s a couple of hundred dollars a year more than Finland or Sweden, but nothing dramatic. In the sunny day scenario. Why can't you stop cherry-picking? > And the fees/co-pays are of course not the end of the road. People in Sweden and Finland pay a lot more taxes It's the end of the road with regards to the topic. point-of-service fees. Taxes are assumed already - you get something obvious in return, you do not need to worry about healthcare for you entire life, even if you've been unemployed for a long time. > Median after-tax disposable income, according to the OECD, is $14,000-16,000/year more in the US than Finland or Sweden. Given the US's lack of welfare services this also seem to be a sunny day scenario. Your costs for daycare, education, rents etc are significantly higher and require that kind of disposable income to just save up to. Furthermore, this is only relevant if you think that more disposable income somehow automatically translates to more happiness and quality-of-life, which we know that it doesn't beyond a certain point.

Most countries with “universal healthcare” actually have some sort of “universal health insurance.” And it’s usually not free at the point of service. Finland for example has a user fees and co-pays at the point of service.

jahaja 6y ago
I think it's pretty relevant to post how large these Finnish fees and co-pays are compared to the US? It comes across as pretty dishonest to omit that the fee is almost symbolic in comparison. In Sweden it's like 200SEK (~$20) per visit and it seems to be 20 euro in Finland. And both fees have a cap for people needing a lot of care.
- tptacek 6y ago
  The average US insurance copay for a doctor's office visit is, wait for it, $20. Retail health care is not where the expense insanity in the US system kicks in.
  - jahaja 6y ago
    What's your point? This is more or less the end of the road in Sweden and Finland with regards to fees/co-pays, there's no difference with regards to severity. Not sure why you guys are so eager to try a "it's actually pretty much the same as here" when it clearly requires an extremely superficial look.
    - tptacek 6y ago
      I don't know who "you guys are"; I'm a liberal Democrat and Rayiner is not. I'm just saying that in the retail health care setting we always seem to be talking about, the cost-sharing expectations of Europe are quite comparable to those of insured people in the US. This is a problem for people whose argument about the failings of US health care condenses to "insurance isn't enough". The US health care system has deep, systemic problems! It's just probably not the copay problem.
      - jahaja 6y ago
        > I'm a liberal Democrat and Rayiner is not. Well, if so, your seemingly minor differences judging from the threads you both participate in here on HN seems pretty much symptomatic for US politics to me. Two parties, both business parties, and minor differences in their realpolitik. > It's just probably not the copay problem I'm regularly hearing stories about people having to pay hundreds or thousands of dollars for procedures, even chronic things like insulin.
    - rayiner 6y ago
      You don’t have to speculate about this stuff. The OECD tracks out of pocket healthcare spending: https://www.oecd.org/health/health-systems/OECD-Focus-on-Out-of-Pocket-Spending-April-2019.pdf https://www.oecd.org/health/health-systems/OECD-Focus-on-Out... It’s a couple of hundred dollars a year more than Finland or Sweden, but nothing dramatic. And the fees/co-pays are of course not the end of the road. People in Sweden and Finland pay a lot more taxes. They pay thousands of dollars more every year, even when they don’t get sick. Median after-tax disposable income, according to the OECD, is $14,000-16,000/year more in the US than Finland or Sweden. Now, of course, Americans spend a significant part of that difference on deductibles, premiums, etc. But in most states it’s a few thousand dollars a year on average. https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket https://www.commonwealthfund.org/publications/issue-briefs/2...
      - jahaja 6y ago
        > It’s a couple of hundred dollars a year more than Finland or Sweden, but nothing dramatic. In the sunny day scenario. Why can't you stop cherry-picking? > And the fees/co-pays are of course not the end of the road. People in Sweden and Finland pay a lot more taxes It's the end of the road with regards to the topic. point-of-service fees. Taxes are assumed already - you get something obvious in return, you do not need to worry about healthcare for you entire life, even if you've been unemployed for a long time. > Median after-tax disposable income, according to the OECD, is $14,000-16,000/year more in the US than Finland or Sweden. Given the US's lack of welfare services this also seem to be a sunny day scenario. Your costs for daycare, education, rents etc are significantly higher and require that kind of disposable income to just save up to. Furthermore, this is only relevant if you think that more disposable income somehow automatically translates to more happiness and quality-of-life, which we know that it doesn't beyond a certain point.