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> Americans' satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with

> Americans' satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with veterans or military health insurance… Sounds about right to me. The VA health care system has problems [1] but on the whole doesn't seem worse than the rest of the US healthcare system, maybe better. Anecdote: when my dad retired, my parents lost their insurance through his work, and my mom wasn't eligible for Medicare yet. They looked around at individual insurance options, which were horrible. My mom ended up using her VA benefits and was very glad to have them. The VA has treated my parents quite well, although the VA doesn't seem used to having a lot of female patients my mom's age. [1] https://www.pbs.org/newshour/nation/veterans-affairs-backlog-files-were-stacked-so-high-they-posed-a-safety-risk-to-va-staff-1 https://www.pbs.org/newshour/nation/veterans-affairs-backlog...

sdoering 5y ago
Wow. I am always stunned reading accounts like this. I can't imagine living in a country where you loose health care when loosing a job or going into retirement. I have to admit reading posts like yours makes me realize how lucky I feel with the German system. And yes. I am well aware of the monthly costs that brings in terms of around 14% of my salary for health insurance. And of the limitations. But to me this still sounds better than the risk of loosing everything due to an accident. I am glad your parents found a way with your mom's benefits.
- scottlamb 5y ago
  It's a terrible system, and it was more terrible before Obamacare. In general when someone retires they're old enough to be eligible for Medicare (government-sponsored health care). My dad was. But my mom was just enough younger that she wasn't eligible for Medicare when he retired. There were (and still are) all kinds of weird gaps like this.
  - aksss 5y ago
    Obamacare created new gaps that absolutely sucked - made over 58k and self employed? No subsidies for you and paying a skyrocketing premium higher than any reasonable home mortgage with a 10k deductible. Completely unrealistic. And then the IRS hit you for thousands in penalties via the individual mandate. I lived through that, uninsured, for five years or so as a business owner - to “rich” to get subsidies, too poor to afford 20k+ per year for nothing except a theoretical out-of-pocket max (I say theoretical because there are many exceptions, loopholes, and the annual reset). Being hammered by the IRS for this was.. just.. swell. So for me Obamacare sucked because it made the cost of individual market plans completely unaffordable and then taxed me for not being able to afford it. As a business owner responsible for employing others, it seemed especially ridiculous because here was a strong disincentive for me to continue on, which would mean a negative ripple effect beyond just me, i.e. layoffs, if I shuttered the operation. Once the individual mandate went away, and some new options for employer cost sharing like QSEHRA/ICHRA came about, it has gotten a bit more manageable, but most small business owners I know still struggle with healthcare. Cost sharing programs like CHM are about the only workable alternative but they don’t offer the kind of bankruptcy protection a solid insurance premium would cover, and they are religious by nature. Alternatively, DNR and a term life insurance policy. Best option is to be married, have spouse work for the man to get into corporate group plan for family, while you grow your business enough to sustain an insurance scheme. But it sucks out there on the individual market - the raw actuarial numbers to insure you are bad - and subsidies disappear quickly with any amount of AGI. Since the vast majority of Americans are on employer-paid healthcare plans, this is a view into it that most don’t see. The cynical side of me (as a small business owner) says this is by design to keep you working for corporate America - consolidation of labor, consolidation of the profits. For me, Obamacare further entrenched this aspect of the system, which has become more terrible, not less.
    - sdoering 5y ago
      I see how this sucks for you. Just out of curiosity I calculated roughly the cost in Germany. If you were self employed and made 5.000 € a month your health insurance would be somewhat around 900 € per month. Partly tax deductible if I am not mistaken. So quite a bit of money. But probably manageable for many/most people. I am lucky. As I only do freelance work on the side I am insured via what I pay from my main income. So no additional costs for me as long as I don't make more on the side than in my main job.
- qgin 5y ago
  For what it’s worth, currently you can get a mid-tier Obamacare / ACA health insurance plan for no more than 8.5% of your income. It’s a big jump to have a new expense of 8.5% for sure, but we do have that option now.
  - mcguire 5y ago
    Does that subsidy depend on what state you live in? AFAICT, it doesn't apply here in scenic Alabama.
    - qgin 5y ago
      From what I can tell, Alabama has all the regular subsidies for ACA plans. What they don’t have is Medicaid expansion. The federal government offers states money to expand Medicaid to anyone making less than the minimum needed for ACA plans. Some states like Alabama have refused the money and continue to only offer it to specific subgroups of low income people, usually only after they spent 100% of their assets also.

sdoering 5y ago

Wow. I am always stunned reading accounts like this. I can't imagine living in a country where you loose health care when loosing a job or going into retirement. I have to admit reading posts like yours makes me realize how lucky I feel with the German system. And yes. I am well aware of the monthly costs that brings in terms of around 14% of my salary for health insurance. And of the limitations. But to me this still sounds better than the risk of loosing everything due to an accident. I am glad your parents found a way with your mom's benefits.

scottlamb 5y ago
It's a terrible system, and it was more terrible before Obamacare. In general when someone retires they're old enough to be eligible for Medicare (government-sponsored health care). My dad was. But my mom was just enough younger that she wasn't eligible for Medicare when he retired. There were (and still are) all kinds of weird gaps like this.
- aksss 5y ago
  Obamacare created new gaps that absolutely sucked - made over 58k and self employed? No subsidies for you and paying a skyrocketing premium higher than any reasonable home mortgage with a 10k deductible. Completely unrealistic. And then the IRS hit you for thousands in penalties via the individual mandate. I lived through that, uninsured, for five years or so as a business owner - to “rich” to get subsidies, too poor to afford 20k+ per year for nothing except a theoretical out-of-pocket max (I say theoretical because there are many exceptions, loopholes, and the annual reset). Being hammered by the IRS for this was.. just.. swell. So for me Obamacare sucked because it made the cost of individual market plans completely unaffordable and then taxed me for not being able to afford it. As a business owner responsible for employing others, it seemed especially ridiculous because here was a strong disincentive for me to continue on, which would mean a negative ripple effect beyond just me, i.e. layoffs, if I shuttered the operation. Once the individual mandate went away, and some new options for employer cost sharing like QSEHRA/ICHRA came about, it has gotten a bit more manageable, but most small business owners I know still struggle with healthcare. Cost sharing programs like CHM are about the only workable alternative but they don’t offer the kind of bankruptcy protection a solid insurance premium would cover, and they are religious by nature. Alternatively, DNR and a term life insurance policy. Best option is to be married, have spouse work for the man to get into corporate group plan for family, while you grow your business enough to sustain an insurance scheme. But it sucks out there on the individual market - the raw actuarial numbers to insure you are bad - and subsidies disappear quickly with any amount of AGI. Since the vast majority of Americans are on employer-paid healthcare plans, this is a view into it that most don’t see. The cynical side of me (as a small business owner) says this is by design to keep you working for corporate America - consolidation of labor, consolidation of the profits. For me, Obamacare further entrenched this aspect of the system, which has become more terrible, not less.
  - sdoering 5y ago
    I see how this sucks for you. Just out of curiosity I calculated roughly the cost in Germany. If you were self employed and made 5.000 € a month your health insurance would be somewhat around 900 € per month. Partly tax deductible if I am not mistaken. So quite a bit of money. But probably manageable for many/most people. I am lucky. As I only do freelance work on the side I am insured via what I pay from my main income. So no additional costs for me as long as I don't make more on the side than in my main job.
qgin 5y ago
For what it’s worth, currently you can get a mid-tier Obamacare / ACA health insurance plan for no more than 8.5% of your income. It’s a big jump to have a new expense of 8.5% for sure, but we do have that option now.
- mcguire 5y ago
  Does that subsidy depend on what state you live in? AFAICT, it doesn't apply here in scenic Alabama.
  - qgin 5y ago
    From what I can tell, Alabama has all the regular subsidies for ACA plans. What they don’t have is Medicaid expansion. The federal government offers states money to expand Medicaid to anyone making less than the minimum needed for ACA plans. Some states like Alabama have refused the money and continue to only offer it to specific subgroups of low income people, usually only after they spent 100% of their assets also.