5 ms·

I just read an article about quiet / dream jobs (park ranger etc.) In it, every single person has a side gig(s) or is otherwise making decisions on their caree

I just read an article about quiet / dream jobs (park ranger etc.) In it, every single person has a side gig(s) or is otherwise making decisions on their careers based on medical coverage. Every one of them! One of the people says most people leave when they turn 26 because they can't stay on their parents' health insurance. What?! > And like other dream jobs I learned about, it’s not enough to survive on: During > off-seasons, Krumbholz also works as a substitute teacher and an aquarium dolphin > tank cleaner; since being on university health insurance would mean she’d constantly > lose it during the off-season, Krumbholz decided to stay on the state exchange > instead. The idea that health care is tied to your employer, and your employment status, is so unacceptably broken. I've never heard of anything so broken in terms of the obvious social and economic harm a bad policy is creating. Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it.

peytn 6y ago
That sounds extreme. Without taking sides, I suggest another possibility is that the author may have a bias, agenda, or angle to the story.
xyzelement 6y ago
// Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it. This is not how freedom works. Your argument is akin to saying "freedom from hearing uncomfortable opinions" benefits more people than "freedom of expression" does. On the broader level, I got to experience healthcare in the US both as a broke-ass immigrant child and as a working adult. It ranged from good to amazing in terms of availability of appointments, treatments, quality and comfort. Night and day beyond what I experienced in the USSR as a kid. So while people are shitting on the system we have, many people find it excellent and amazing and we like the freedom to continue enjoying it.
- Trill-I-Am 6y ago
  Would the general public of other developed nations be happier if their healthcare systems were more like the US's?
  - LouisSayers 6y ago
    Haha nope, ya’ll be crazy
  - dghlsakjg 6y ago
    I've lived in the US, and now live in Canada. Despite right-wing propaganda that we're all flocking to the states for care (never met a single person who has even considered that), or that we're all dying on years long wait lists (there is an element of truth to that, but it's a triage system. So cancer patients get priority for surgery before the skier who blew his ACL). I still have yet to meet a single person who doesn't think the US system is batshit crazy. Canadians recognize that their system has problems, and can be improved (which is true of ANY complex system). But they also don't think that the US system is functional or desirable. I know that the nearest border crossing to me regularly has ambulances waiting for people that preferred to travel sick or injured than seek healthcare in the US. In other words, people literally flee the country to avoid being treated in the US.
    - pvaldes 6y ago
      Is curious, but I had heard exactly the same advice before. In case of a minor accident or health issue as tourist in US, try to leave the country ASAP unless you have a solid travel insurance. In any case you will be not allowed to fly with a fracture (if I'm not wrong).
  - pvaldes 6y ago
    I doubt it. In any case we have public and private hospitals. Paying an insurance for assuring a "premium" service with better rooms or faster treatments (closer to the US system) is also an option.
- bcrosby95 6y ago
  My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.
  - xyzelement 6y ago
    There definitely had been a few snags with insurance that we had to work through - not claiming it's perfect. However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world. My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered impractical elsewhere in the world. For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's "wasted" as it just confirms A. But the other 10% of the time, it saves the life. We make a different tradeoff in the US, some of us prefer this trade off.
    - CogitoCogito 6y ago
      > For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's not needed. But the other 10% of the time, it saves the life. This just plain isn't true in general. I grew up in the US with probably the best insurance of anyone I've ever known. I've also lived in Sweden with the state-run insurance (without any private addition). I've had great care in the US. I've had great care in Sweden. In fact, my care in Sweden has honestly probably been better in my cases including where I had overuse injury to my knee due to sports where they really could just say "well quit running so much and let your body rest and leave the healthcare system to those not actively inducing their own injury", but they did not. Fast MRIs, fast diagnosis, fast help, fast everything. I understand this is entirely anecdotal, but the fact is there are many much cheaper systems out there run by governments that actually function _better_ than the US system even for those in the US with good insurance.
- throwaway4220 6y ago
  YMMV (as I'm sure the below comments will show you) on the efficacy of the US healthcare system. My experience ranged from 1/10 (like denying emergency care until I fought for it) to 10/10 (same-day treatment after diagnosis). Even from the supply side, I have little power on how to help even my own patients navigate the system unless it's an urgent/emergent need. It is important to hear the system is working well for some; we should focus on improving it for more people.
- CoolGuySteve 6y ago
  That may be true but the USSR is a collapsed state, we should be comparing wealthy countries. According to this the US is mostly in the high top 10 for outcomes in cancer and cardiovascular disease treatment outcomes: https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare#Outcome_of_cardiovascular_disease_care https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... But the US spends more than double the OECD average per capita to achieve those marginal gains: https://upload.wikimedia.org/wikipedia/commons/thumb/0/0b/OECD_health_expenditure_per_capita_by_country.svg/1920px-OECD_health_expenditure_per_capita_by_country.svg.png https://upload.wikimedia.org/wikipedia/commons/thumb/0/0b/OE... There's an argument to be made that the cost overruns are paying for better outcomes, or maybe the outcomes have some sample bias due to Americans being less healthy, or sicker people are seeking treatment in the US. But on the other hand, the gains are so marginal that those costs might also be due to significant corruption and regulatory capture.
  - xyzelement 6y ago
    I didn't make this clear - I agree with you about the USSR, but the point I meant to make is that on metrics like cost and availability of care, it would look "better" than the US.
    - stjohnswarts 6y ago
      No one who is legit just compares cost and availability they are going to also include the health levels of the nation, time to actually getting an appointment, time to get a surgery for a condition, etc. You can't just pick out two variables and say "see I'm right!" . There are a ton of European health markets that are superior to the US market when comparing multiple variables. We need to copy them or do something very similar rather than being stubborn assholes and think everything has to be home grown.
- stjohnswarts 6y ago
  You're being single minded here. You should compare it to what is available in Europe, Cuba, Canada, etc not what's going on in Russia. We want everyone to have good health care, not just people in silicon valley and the tech industry who by and large to get good insurance.
cmurf 6y ago
If folks had to butcher their own cow, there'd be more vegetarians. And if folks had to shop and pay for their own health care plans on exchanges like the self-employed do, we'd have universal health care.
spaetzleesser 6y ago
Employer based health insurance should be abolished. There should be one risk pool either nation or state wide and within that everybody can get insurance for the same price. It would reduce a lot of administrative effort in companies (why does my employer have to worry about my health insurance but not my car insurance?) and allow people to change jobs without worrying about health care. Religious employers also couldn't control things like birth control because health insurance would be none of their business.
- stjohnswarts 6y ago
  I like this idea, especially nation wide. I think the US should set one up along side private policies though as a stepping stone so people can see/envy it. You will never ever get rid of private insurance in one fell swoop it will take steps.
- TheOsiris 6y ago
  it should be, and it needs to be if we ever want to fix this problem, but it'll be political suicide for anyone that even says this out loud. corporations would be all for it to. (majority of) people with jobs have no idea how bad/expensive healthcare really is. they have excellent insurance coverage and they pay very little for it. if we make them responsible for buying their own it'll be impossibly expensive. but this is exactly what they need to realize so that we can have the political movement to overhaul the entire system
  - spaetzleesser 6y ago
    "they pay very little for it." That belief is the problem. You pay for it with reduced salary. Problem is that this fact is being hidden. Then you also have your employer choose insurance plans for you but their selection criteria are most likely for their own benefit.
y-c-o-m-b 6y ago
My first question to a potential new employer has become "what are your health insurance benefits and how much do you cover?" rather than "what's the salary range you're hiring for?" (although this still comes second). If it's anything less than 80% employer-paid coverage or they don't offer traditional PPO plans, it's an automatic withdrawal of my application. I've recently found I now need to add another filter to this: "WHO is your insurance through?" because apparently even 90% employer paid health insurance through UnitedHealthcare still sucks compared to inferior coverage through BlueCross or Aetna. I had to switch primary care doctors for everyone in my family (me, wife, kids all had different docs) because none of them were in network with United. Confused by this, I called around. I found out doctors offices loathe dealing with UHC due to UHC's reluctance to pay or the generally obnoxious claims process. Their "in-network" providers is contained to a much smaller list of providers that put up with their bullshit. I'm seriously considering leaving my current employer (which I'm very happy with) for this reason alone. Lack of reliable (or any) health insurance is the #1 reason I don't take contract jobs even though they're more attractive to me.

peytn 6y ago

That sounds extreme. Without taking sides, I suggest another possibility is that the author may have a bias, agenda, or angle to the story.

xyzelement 6y ago

// Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it. This is not how freedom works. Your argument is akin to saying "freedom from hearing uncomfortable opinions" benefits more people than "freedom of expression" does. On the broader level, I got to experience healthcare in the US both as a broke-ass immigrant child and as a working adult. It ranged from good to amazing in terms of availability of appointments, treatments, quality and comfort. Night and day beyond what I experienced in the USSR as a kid. So while people are shitting on the system we have, many people find it excellent and amazing and we like the freedom to continue enjoying it.

Trill-I-Am 6y ago
Would the general public of other developed nations be happier if their healthcare systems were more like the US's?
- LouisSayers 6y ago
  Haha nope, ya’ll be crazy
- dghlsakjg 6y ago
  I've lived in the US, and now live in Canada. Despite right-wing propaganda that we're all flocking to the states for care (never met a single person who has even considered that), or that we're all dying on years long wait lists (there is an element of truth to that, but it's a triage system. So cancer patients get priority for surgery before the skier who blew his ACL). I still have yet to meet a single person who doesn't think the US system is batshit crazy. Canadians recognize that their system has problems, and can be improved (which is true of ANY complex system). But they also don't think that the US system is functional or desirable. I know that the nearest border crossing to me regularly has ambulances waiting for people that preferred to travel sick or injured than seek healthcare in the US. In other words, people literally flee the country to avoid being treated in the US.
  - pvaldes 6y ago
    Is curious, but I had heard exactly the same advice before. In case of a minor accident or health issue as tourist in US, try to leave the country ASAP unless you have a solid travel insurance. In any case you will be not allowed to fly with a fracture (if I'm not wrong).
- pvaldes 6y ago
  I doubt it. In any case we have public and private hospitals. Paying an insurance for assuring a "premium" service with better rooms or faster treatments (closer to the US system) is also an option.
bcrosby95 6y ago
My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.
- xyzelement 6y ago
  There definitely had been a few snags with insurance that we had to work through - not claiming it's perfect. However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world. My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered impractical elsewhere in the world. For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's "wasted" as it just confirms A. But the other 10% of the time, it saves the life. We make a different tradeoff in the US, some of us prefer this trade off.
  - CogitoCogito 6y ago
    > For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's not needed. But the other 10% of the time, it saves the life. This just plain isn't true in general. I grew up in the US with probably the best insurance of anyone I've ever known. I've also lived in Sweden with the state-run insurance (without any private addition). I've had great care in the US. I've had great care in Sweden. In fact, my care in Sweden has honestly probably been better in my cases including where I had overuse injury to my knee due to sports where they really could just say "well quit running so much and let your body rest and leave the healthcare system to those not actively inducing their own injury", but they did not. Fast MRIs, fast diagnosis, fast help, fast everything. I understand this is entirely anecdotal, but the fact is there are many much cheaper systems out there run by governments that actually function _better_ than the US system even for those in the US with good insurance.
throwaway4220 6y ago
YMMV (as I'm sure the below comments will show you) on the efficacy of the US healthcare system. My experience ranged from 1/10 (like denying emergency care until I fought for it) to 10/10 (same-day treatment after diagnosis). Even from the supply side, I have little power on how to help even my own patients navigate the system unless it's an urgent/emergent need. It is important to hear the system is working well for some; we should focus on improving it for more people.
CoolGuySteve 6y ago
That may be true but the USSR is a collapsed state, we should be comparing wealthy countries. According to this the US is mostly in the high top 10 for outcomes in cancer and cardiovascular disease treatment outcomes: https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare#Outcome_of_cardiovascular_disease_care https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... But the US spends more than double the OECD average per capita to achieve those marginal gains: https://upload.wikimedia.org/wikipedia/commons/thumb/0/0b/OECD_health_expenditure_per_capita_by_country.svg/1920px-OECD_health_expenditure_per_capita_by_country.svg.png https://upload.wikimedia.org/wikipedia/commons/thumb/0/0b/OE... There's an argument to be made that the cost overruns are paying for better outcomes, or maybe the outcomes have some sample bias due to Americans being less healthy, or sicker people are seeking treatment in the US. But on the other hand, the gains are so marginal that those costs might also be due to significant corruption and regulatory capture.
- xyzelement 6y ago
  I didn't make this clear - I agree with you about the USSR, but the point I meant to make is that on metrics like cost and availability of care, it would look "better" than the US.
  - stjohnswarts 6y ago
    No one who is legit just compares cost and availability they are going to also include the health levels of the nation, time to actually getting an appointment, time to get a surgery for a condition, etc. You can't just pick out two variables and say "see I'm right!" . There are a ton of European health markets that are superior to the US market when comparing multiple variables. We need to copy them or do something very similar rather than being stubborn assholes and think everything has to be home grown.
stjohnswarts 6y ago
You're being single minded here. You should compare it to what is available in Europe, Cuba, Canada, etc not what's going on in Russia. We want everyone to have good health care, not just people in silicon valley and the tech industry who by and large to get good insurance.

cmurf 6y ago

If folks had to butcher their own cow, there'd be more vegetarians. And if folks had to shop and pay for their own health care plans on exchanges like the self-employed do, we'd have universal health care.

spaetzleesser 6y ago

Employer based health insurance should be abolished. There should be one risk pool either nation or state wide and within that everybody can get insurance for the same price. It would reduce a lot of administrative effort in companies (why does my employer have to worry about my health insurance but not my car insurance?) and allow people to change jobs without worrying about health care. Religious employers also couldn't control things like birth control because health insurance would be none of their business.

stjohnswarts 6y ago
I like this idea, especially nation wide. I think the US should set one up along side private policies though as a stepping stone so people can see/envy it. You will never ever get rid of private insurance in one fell swoop it will take steps.
TheOsiris 6y ago
it should be, and it needs to be if we ever want to fix this problem, but it'll be political suicide for anyone that even says this out loud. corporations would be all for it to. (majority of) people with jobs have no idea how bad/expensive healthcare really is. they have excellent insurance coverage and they pay very little for it. if we make them responsible for buying their own it'll be impossibly expensive. but this is exactly what they need to realize so that we can have the political movement to overhaul the entire system
- spaetzleesser 6y ago
  "they pay very little for it." That belief is the problem. You pay for it with reduced salary. Problem is that this fact is being hidden. Then you also have your employer choose insurance plans for you but their selection criteria are most likely for their own benefit.

y-c-o-m-b 6y ago

My first question to a potential new employer has become "what are your health insurance benefits and how much do you cover?" rather than "what's the salary range you're hiring for?" (although this still comes second). If it's anything less than 80% employer-paid coverage or they don't offer traditional PPO plans, it's an automatic withdrawal of my application. I've recently found I now need to add another filter to this: "WHO is your insurance through?" because apparently even 90% employer paid health insurance through UnitedHealthcare still sucks compared to inferior coverage through BlueCross or Aetna. I had to switch primary care doctors for everyone in my family (me, wife, kids all had different docs) because none of them were in network with United. Confused by this, I called around. I found out doctors offices loathe dealing with UHC due to UHC's reluctance to pay or the generally obnoxious claims process. Their "in-network" providers is contained to a much smaller list of providers that put up with their bullshit. I'm seriously considering leaving my current employer (which I'm very happy with) for this reason alone. Lack of reliable (or any) health insurance is the #1 reason I don't take contract jobs even though they're more attractive to me.