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Everyone is born and at some point will die. The costs associated with this vary hugely but the certainty of those two end points are inescapable. Almost every

Everyone is born and at some point will die. The costs associated with this vary hugely but the certainty of those two end points are inescapable. Almost every other developed country in the world recognises that and shares both the risks and the costs recognising that health is a golden crown worn by (and invisible to) those who have it. As someone with a spinal injury who would be most likely bankrupt and unemployed in the US I just don't understand why you don't get a proper, profit-free healthcare system. You spend the most on it in the world and don't get the greatest outcomes!

bpt3 10mo ago
I don't disagree with anything you said, but the simple answer to your question is that most American households are happy with their current health insurance and don't want it to change, so we keep patching the current (severely flawed) system as "needed" rather than starting over with a new one or making what would be seen as radical changes. --- Edit --- For the kneejerk downvoters who seem very confused, this was released yesterday: https://thehill.com/policy/healthcare/5650010-survey-aca-coverage-satisfaction/ https://thehill.com/policy/healthcare/5650010-survey-aca-cov... This has been an issue for decades now, with countless polls to back it up.
- colinbartlett 10mo ago
  Citation needed.
  - bpt3 10mo ago
    From yesterday, after a 2 second google search: https://thehill.com/policy/healthcare/5650010-survey-aca-coverage-satisfaction/ https://thehill.com/policy/healthcare/5650010-survey-aca-cov... Feel free to look at the many, many, many alternative polls over the years. This is well known to anyone who has done any research into the topic at all.
    - toomuchtodo 10mo ago
      Take the poll in 2026 after ACA subsides evaporate and Medicaid cuts. Highest satisfaction is for government run insurance (Medicare, Medicaid, Tricare). https://www.nbcnews.com/politics/politics-news/poll-are-satisfied-health-insurance-quarter-report-denials-delays-rcna248908 https://www.nbcnews.com/politics/politics-news/poll-are-sati... ("Overall, 82% of Americans said they’re satisfied with their health care coverage, including a third who said they are very satisfied with their current coverage. The group that reported being the most satisfied were older adults, with 9 in 10 Americans over 65 years old saying they were satisfied. And 42% in that age group reported being “very satisfied.”. Roughly 9 in 10 of those who have public health insurance coverage through Medicare or Medicaid also reported being satisfied with coverage, compared to 77% of those with private health care coverage.") https://www.kff.org/medicare/overall-satisfaction-with-medicare-is-high-but-beneficiaries-under-age-65-with-disabilities-experience-more-insurance-problems-than-older-beneficiaries/ https://www.kff.org/medicare/overall-satisfaction-with-medic... https://www.citizen.org/article/public-support-for-medicare-for-all/ https://www.citizen.org/article/public-support-for-medicare-... ("Support for Medicare-for-All continues to rise, whether in Congress, state legislatures, or among the American people. Recent polls indicate that six in ten Americans support Medicare-for-All. In addition, more than 60 percent believe that government is responsible for ensuring health coverage for all Americans. And nearly 70 percent of all voters, including battleground voters, identify health care as an important issue in upcoming elections.") My comment with citations from six years ago showing the trend holds: https://news.ycombinator.com/item?id=22550774 https://news.ycombinator.com/item?id=22550774 (March 11th, 2020) Americans With Government Health Plans Most Satisfied - https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx https://news.gallup.com/poll/186527/americans-government-hea... - November 6th, 2015
      - bpt3 10mo ago
        Yes, it's noted in the poll I linked (which is the same one as your first link) that the highest satisfaction is with government run insurance. Not enough people are on ACA with subsidies to move the poll results that much, and Medicaid cuts aren't going to make people less satisfied with their private insurance. I have no idea why you and so many other people seem to be taking my explanation as to why the US doesn't adopt universal socialized medicine as some sort of endorsement of the status quo.
- calibas 10mo ago
  That poll doesn't say they're happy with their health insurance, it says they're at least somewhat satisfied with the coverage. You'd see very different results if you asked about health insurance prices. The problem is the cost.
  - bpt3 10mo ago
    I believe most people would incorporate the value received into their satisfaction rating. Most people also don't have any idea how much their insurance costs in total or how it compares to alternatives, so that would be a challenging question to write with any reasonable expectation of getting a coherent response. > The problem is the cost. You could say this about almost anything that isn't free, and could still say it about a number of things even if they were free.
JumpCrisscross 10mo ago
> don't understand why you don't get a proper, profit-free healthcare system. You spend the most on it in the world and don't get the greatest outcomes American healthcare for the top 10 to 15% (about $150k+) is the best in the world. By a long shot. (The bottom ninety-something percent of the world's top 1% get their care here for a reason.) Another 40% are covered by Medicare or Medicaid [1] which, while nothing to brag about, exceeds the median OECD healthcare experience. That leaves half of the population with crappy employer-provided healthcare, the VA, scams or no insurance at all. For most of them, until they have an accident, this coverage is fine. In summary, you have a system that works terrifically for the rich, well for the poor and old, and well enough for the rest that reform is challenging. [1] https://www.census.gov/library/publications/2024/demo/p60-284.html#:~:text=Medicaid%20%2818.9,Medicare%20%2818.9&text=Whereas%2C%20Medicare,of%20people. https://www.census.gov/library/publications/2024/demo/p60-28...
- IAmBroom 10mo ago
  "In summary, you have a system that works ... well for the poor". You don't actually know any poor people, do you? Their lives are not governed by your theoretical models. And as the GP said, our healthcare - not the best of the best of our healthcare, as you cherrypicked, but the kind ordinary people have - is appalling overpriced for its mediocre quality.
  - deleted 10mo ago
    [deleted]
trimethylpurine 10mo ago
Recently, friends and family in other countries have asked about health care in the US and I've been very surprised by what they imagine is going on here. Let's compare notes? If I go to a hospital (emergency) for any reason, I will be seen within an hour at worst. If I'm bleeding or something I'll be seen immediately. A clinic for surgery might be same day or up to a couple of weeks, depends on severity. More specialized surgery could be 5-6 weeks. American average monthly cost for health insurance is around $600 for a family. Individuals without a family are around $450 so they kind of get screwed. The expenditures for health care, including the $600/mo are tax deductible. This number can go as high as $1200 in places like New York where income is significantly higher as is cost of living. Overall, averaging co-payment and deductible with accidents, you should expect to spend around $3,000 / yr on average per person in total for health care as part of a family in the US. This number varies greatly by age, and both income and health care in the US is socialized so your wages determine your healthcare liability. (Make more money? Get less social services.) This should cover everyone, but you have issues where poor people don't file taxes, and don't file for health care. Those people will still be seen in an emergency room. Conversely, my friends and family in other countries with "free" healthcare pay roughly the same total for their medical portion of tax liability as I pay for health care in total. But their wait times are astronomically greater when it comes to receiving care. I've often helped financially because their wait time for something like shoulder surgery might be 10 to 12 months or even longer, but the same doctor will see them in a week if it's paid privately. So I've worked out payment plans where I contribute $1k/mo for their "add-on" private care so that they can be seen in a reasonable amount of time. That's in addition to what they already paid in medical tax. Maybe that helps to understand. From my perspective, in a lot of countries you are told that you have free healthcare, but in fact you're paying for it in taxes, and then someone in the US will still have to pay for it when you actually need it anyway. Double payment. Hope you've got friends. (Maybe that's not true for everyone, I'm just going by what I've seen and paid for myself for my own family.) I personally think that Europe and other countries don't have better health care, it's much worse. I've lived in several countries for 1-2 months to years in each and I've never seen health care remotely on the level that I see in the US. I would venture to guess it's the best in the world. If it's hard to understand how people live in a modern high tech country without healthcare, it's because they don't. It's just about which rich person is paying for it. Health care is very expensive, and that's true around the world. And around the world, if you don't file/register for health care, your outcomes are generally much worse. The US is no different in that regard.

bpt3 10mo ago

I don't disagree with anything you said, but the simple answer to your question is that most American households are happy with their current health insurance and don't want it to change, so we keep patching the current (severely flawed) system as "needed" rather than starting over with a new one or making what would be seen as radical changes. --- Edit --- For the kneejerk downvoters who seem very confused, this was released yesterday: https://thehill.com/policy/healthcare/5650010-survey-aca-coverage-satisfaction/ https://thehill.com/policy/healthcare/5650010-survey-aca-cov... This has been an issue for decades now, with countless polls to back it up.

colinbartlett 10mo ago
Citation needed.
- bpt3 10mo ago
  From yesterday, after a 2 second google search: https://thehill.com/policy/healthcare/5650010-survey-aca-coverage-satisfaction/ https://thehill.com/policy/healthcare/5650010-survey-aca-cov... Feel free to look at the many, many, many alternative polls over the years. This is well known to anyone who has done any research into the topic at all.
  - toomuchtodo 10mo ago
    Take the poll in 2026 after ACA subsides evaporate and Medicaid cuts. Highest satisfaction is for government run insurance (Medicare, Medicaid, Tricare). https://www.nbcnews.com/politics/politics-news/poll-are-satisfied-health-insurance-quarter-report-denials-delays-rcna248908 https://www.nbcnews.com/politics/politics-news/poll-are-sati... ("Overall, 82% of Americans said they’re satisfied with their health care coverage, including a third who said they are very satisfied with their current coverage. The group that reported being the most satisfied were older adults, with 9 in 10 Americans over 65 years old saying they were satisfied. And 42% in that age group reported being “very satisfied.”. Roughly 9 in 10 of those who have public health insurance coverage through Medicare or Medicaid also reported being satisfied with coverage, compared to 77% of those with private health care coverage.") https://www.kff.org/medicare/overall-satisfaction-with-medicare-is-high-but-beneficiaries-under-age-65-with-disabilities-experience-more-insurance-problems-than-older-beneficiaries/ https://www.kff.org/medicare/overall-satisfaction-with-medic... https://www.citizen.org/article/public-support-for-medicare-for-all/ https://www.citizen.org/article/public-support-for-medicare-... ("Support for Medicare-for-All continues to rise, whether in Congress, state legislatures, or among the American people. Recent polls indicate that six in ten Americans support Medicare-for-All. In addition, more than 60 percent believe that government is responsible for ensuring health coverage for all Americans. And nearly 70 percent of all voters, including battleground voters, identify health care as an important issue in upcoming elections.") My comment with citations from six years ago showing the trend holds: https://news.ycombinator.com/item?id=22550774 https://news.ycombinator.com/item?id=22550774 (March 11th, 2020) Americans With Government Health Plans Most Satisfied - https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx https://news.gallup.com/poll/186527/americans-government-hea... - November 6th, 2015
    - bpt3 10mo ago
      Yes, it's noted in the poll I linked (which is the same one as your first link) that the highest satisfaction is with government run insurance. Not enough people are on ACA with subsidies to move the poll results that much, and Medicaid cuts aren't going to make people less satisfied with their private insurance. I have no idea why you and so many other people seem to be taking my explanation as to why the US doesn't adopt universal socialized medicine as some sort of endorsement of the status quo.
calibas 10mo ago
That poll doesn't say they're happy with their health insurance, it says they're at least somewhat satisfied with the coverage. You'd see very different results if you asked about health insurance prices. The problem is the cost.
- bpt3 10mo ago
  I believe most people would incorporate the value received into their satisfaction rating. Most people also don't have any idea how much their insurance costs in total or how it compares to alternatives, so that would be a challenging question to write with any reasonable expectation of getting a coherent response. > The problem is the cost. You could say this about almost anything that isn't free, and could still say it about a number of things even if they were free.

JumpCrisscross 10mo ago

> don't understand why you don't get a proper, profit-free healthcare system. You spend the most on it in the world and don't get the greatest outcomes American healthcare for the top 10 to 15% (about $150k+) is the best in the world. By a long shot. (The bottom ninety-something percent of the world's top 1% get their care here for a reason.) Another 40% are covered by Medicare or Medicaid [1] which, while nothing to brag about, exceeds the median OECD healthcare experience. That leaves half of the population with crappy employer-provided healthcare, the VA, scams or no insurance at all. For most of them, until they have an accident, this coverage is fine. In summary, you have a system that works terrifically for the rich, well for the poor and old, and well enough for the rest that reform is challenging. [1] https://www.census.gov/library/publications/2024/demo/p60-284.html#:~:text=Medicaid%20%2818.9,Medicare%20%2818.9&text=Whereas%2C%20Medicare,of%20people. https://www.census.gov/library/publications/2024/demo/p60-28...

IAmBroom 10mo ago
"In summary, you have a system that works ... well for the poor". You don't actually know any poor people, do you? Their lives are not governed by your theoretical models. And as the GP said, our healthcare - not the best of the best of our healthcare, as you cherrypicked, but the kind ordinary people have - is appalling overpriced for its mediocre quality.
- deleted 10mo ago
  [deleted]

trimethylpurine 10mo ago

Recently, friends and family in other countries have asked about health care in the US and I've been very surprised by what they imagine is going on here. Let's compare notes? If I go to a hospital (emergency) for any reason, I will be seen within an hour at worst. If I'm bleeding or something I'll be seen immediately. A clinic for surgery might be same day or up to a couple of weeks, depends on severity. More specialized surgery could be 5-6 weeks. American average monthly cost for health insurance is around $600 for a family. Individuals without a family are around $450 so they kind of get screwed. The expenditures for health care, including the $600/mo are tax deductible. This number can go as high as $1200 in places like New York where income is significantly higher as is cost of living. Overall, averaging co-payment and deductible with accidents, you should expect to spend around $3,000 / yr on average per person in total for health care as part of a family in the US. This number varies greatly by age, and both income and health care in the US is socialized so your wages determine your healthcare liability. (Make more money? Get less social services.) This should cover everyone, but you have issues where poor people don't file taxes, and don't file for health care. Those people will still be seen in an emergency room. Conversely, my friends and family in other countries with "free" healthcare pay roughly the same total for their medical portion of tax liability as I pay for health care in total. But their wait times are astronomically greater when it comes to receiving care. I've often helped financially because their wait time for something like shoulder surgery might be 10 to 12 months or even longer, but the same doctor will see them in a week if it's paid privately. So I've worked out payment plans where I contribute $1k/mo for their "add-on" private care so that they can be seen in a reasonable amount of time. That's in addition to what they already paid in medical tax. Maybe that helps to understand. From my perspective, in a lot of countries you are told that you have free healthcare, but in fact you're paying for it in taxes, and then someone in the US will still have to pay for it when you actually need it anyway. Double payment. Hope you've got friends. (Maybe that's not true for everyone, I'm just going by what I've seen and paid for myself for my own family.) I personally think that Europe and other countries don't have better health care, it's much worse. I've lived in several countries for 1-2 months to years in each and I've never seen health care remotely on the level that I see in the US. I would venture to guess it's the best in the world. If it's hard to understand how people live in a modern high tech country without healthcare, it's because they don't. It's just about which rich person is paying for it. Health care is very expensive, and that's true around the world. And around the world, if you don't file/register for health care, your outcomes are generally much worse. The US is no different in that regard.