4 ms·

European here; I've clicked the link and read the introductory text but I am still not fully informed, so here I ask. Why is Jonathan's health insurance not co

European here; I've clicked the link and read the introductory text but I am still not fully informed, so here I ask. Why is Jonathan's health insurance not covering the treatment? Is it because of the terminality? Or because of the way the US health insurance system works? I have very little experience with American insurance systems, but it seems that the public is asked to fund the costs of a family which was let down by the insurance system, and which desperately asks for more time with Jonathan. Personally, this makes me less inclined to donate; donating would feel like I am throwing money at a problem which a foreign country (one of the richest in the world) is not able to fix itself.

AndrewKemendo 12y ago
Interesting take and I don't necessarily disagree. My guess is that most people who are donating don't have wider policy on their mind, only helping someone fill an individual need. Something analogous to a Red Cross/Crescent which does not want to influence policy directly, only to help individuals.
- sqrt17 12y ago
  I think the comparison to Red Cross/Red Crescent is not quite up to the point: my impression is that, for some things that Europeans see as a matter to be regulated (i.e., force health insurances to include "expensive" patients in their coverage, have the state provide subsidies) people in the US rely on local communities (churches, clubs) or their social network. Hence the notion of "paying it forward": by giving to your community, the community acts as an insurance and is likely to reciprocate if or when you are in a bad position. This is why, for many people, it's a big deal to be an atheist: if the main community for you is the church, you're not just foregoing religious and moral support, but also the material kind. It's certainly an understandable reaction to point out that the problem is bigger than one person on giveitforward.org, and that the US health insurance system with insurers being given cheap excuses like coverage ending with your employment contract (rendering your health coverage useless whenever you have a severe disease) or allowing insurers to retroactively (sometimes by 10 or 20 years) invoke a preexisting-condition clause means that many more people have to beg the last months of subsistence off of their friends, family, and community. Or just sit in a corner and die, if they're not well-connected socially.
  - AndrewKemendo 12y ago
    To further clarify my point though, not giving to this cause won't impact how US health care is managed, it only doesn't help this individual. If thousands of very public uninsured and preventable deaths have happened without a change this likely won't make the difference Not that abstaining is reprehensible
  - nilsimsa 12y ago
    Just to let you know that with Obamacare, a few things have changed. Now if you lose coverage through your employer, you can get it through a state market for health insurance. Also pre-existing conditions are no longer allowed for consideration. But affordability may still be an issue for some.
deleted 12y ago
[deleted]
gress 12y ago
I think criticizing the US Healthcare system is perfectly reasonable. But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future.
- NotOscarWilde 12y ago
  > But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future. No, if you have the funds to both campaign for a systemic solution and help the individuals that are currently in trouble because of the systemic problem, then you are of course free to do so. Suggesting that one is more important of our time, energy and money than the other is, however, a valid opinion [1]. [1]: It is valid if my assumptions about the insurance not covering Jonathan and other such cases were true; that may not be so.
  - gress 12y ago
    I agree that this alternative might be valid. I was merely responding to what you actually said - which was not that you were putting your resources elsewhere, but that you simply didn't want to donate to the individual.
Zarkonnen 12y ago
I have to agree. This keeps on happening: fundraisers for people in the US whose insurance is failing to cover their medical bills. Such fundraisers only work if there's a community (such as HN) to appeal to. If your path in life did not lead you into a community to fundraise from, you're just plain doomed. And I'm going to get very political for a moment here: There is a lot of enthusiasm on HN for "market forces", and a lot of hero worship of people who could build their wealth in part because things like a lack of decent healthcare make doing business in the US very cheap. I wish Jonathan Dale nothing but the best. Supporting him because he needs it is great and compassionate, but supporting him because he's One Of Us, when HN is usually so happy to cheerlead for a system that caused this in the first place? It makes me cringe.
- lisper 12y ago
  It shouldn't make you cringe. This is actually (part of) the whole point of Free-Market/Libertarian/Randian/Austrian/Lassez-Faire economics, that people can elect to join social groups for exactly this kind of mutual support rather than being forced to participate in a single support network run by the government. (Note: I personally don't subscribe to this theory, but it is certainly defensible.)
  - Zarkonnen 12y ago
    That just makes me cringe more, sorry. Even if you don't agree with these politics, you are very much describing them in their particular language and framing: a commitment to human dignity described as a use of force.
    - Zarkonnen 12y ago
      Expanding on this: emphasis on support from the community is a mechanism to maintain the status quo. If you are part of a wealthy/powerful community, you can take risks and get the payoff. If you're not, your best bet is to try and conform and join such a powerful community - but you may not be able to. If you're the only X-believer in a community of Y-believers and you get cancer, well, it's not that the Y-believers want you to die, it's just that you're not part of their church and hence your fundraiser will get nowhere. This is not a good system.
hluska 12y ago
Unfortunately, issues like this are not confined to the United States. Both my Aunt and Stepmother are currently fighting cancer. We're Canadian, thus we have universal health care, but each province is responsible for administering its own prescription drug plan. Thus, depending on where you live and your income, you may or may not have decent coverage for cancer drugs. Complicating the situation, there is often a gap between when a drug is approved and when that drug is available for coverage. In our case, we are very lucky. Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. They're relatively lucky - they're both seniors who were well prepared and highly insured. Even luckier, they don't have dependents. I can imagine many, many circumstances under which someone with a family, even in our relatively good health care environment simply could not afford many of the drugs they need. For example, in many cases, complete drug coverage is a premium offering through private insurers. I'm not sure how many healthy people in their mid-30s would really consider premium health insurance a huge priority, especially if they have families. Rather, the tendency could be to assume that their good health will hold and they won't need insurance. In response to your valid criticism, I do agree with most of what you say. But, I would also argue that cancer is an asshole and, if I were in a situation where saving my life could bankrupt my family, I'd sure pray that my community put helping me out above making a political statement about the quality of prescription drug coverage in Canada!!
- jey 12y ago
  > Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. Why is it structured this way? Why don't they just directly bill the insurance without requiring large outlays upfront from the patient?
  - DanBC 12y ago
    In England people pay a small amount (£8.05) for each item on a prescription. One prescription is almost always a single month. Thus, if you have 5 or so meds on a script you'll be paying £40 per month for meds. There is help for prescription costs - people can get deductions for long term meds. Luckily, most people do not pay prescription cost. About 80% of people on a prescription have some exemption or other. There are big problems with medication non-compliance, even for serious life-critical meds (cancer meds; HIV meds; transplant surgery meds) but it seems the cost (free or high cost) is not relevant - non-compliance is similar in the UK and in the US. There are some problems with the English NHS, but "getting access to meds" is not one of them. Unless you count fantastically expensive new cancer meds that add maybe a week of poor quality life.
nilsimsa 12y ago
Even with a good health insurance plan, there are still copay and deductable to consider when you have a major illness that requires hospitalization. This can add up to $1K-$4K per year of treatment depending on how good a plan you have. Then you have all the time and money incurred by your family is getting you better. Time off from work, traveling to visit you, staying with you. If you are lucky you have a good insurance plan and your employer provides disability insurance that covers your lost salary which recovering.
- ma2rten 12y ago
  That is exactly the point... In no other developed country (or should I say in no developed country) do people die because they can not pay their medical bills. The system has to change.
  - chrisBob 12y ago
    Its actually worse than that. Preventative care is not guaranteed, but emergency care, at a hospital emergency room is. This way caring for someone with a minor illness or injury often ends up being more expensive because they can only get help when it becomes life threatening. http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html http://www.washingtonpost.com/wp-dyn/content/article/2007/02...

AndrewKemendo 12y ago

Interesting take and I don't necessarily disagree. My guess is that most people who are donating don't have wider policy on their mind, only helping someone fill an individual need. Something analogous to a Red Cross/Crescent which does not want to influence policy directly, only to help individuals.

sqrt17 12y ago
I think the comparison to Red Cross/Red Crescent is not quite up to the point: my impression is that, for some things that Europeans see as a matter to be regulated (i.e., force health insurances to include "expensive" patients in their coverage, have the state provide subsidies) people in the US rely on local communities (churches, clubs) or their social network. Hence the notion of "paying it forward": by giving to your community, the community acts as an insurance and is likely to reciprocate if or when you are in a bad position. This is why, for many people, it's a big deal to be an atheist: if the main community for you is the church, you're not just foregoing religious and moral support, but also the material kind. It's certainly an understandable reaction to point out that the problem is bigger than one person on giveitforward.org, and that the US health insurance system with insurers being given cheap excuses like coverage ending with your employment contract (rendering your health coverage useless whenever you have a severe disease) or allowing insurers to retroactively (sometimes by 10 or 20 years) invoke a preexisting-condition clause means that many more people have to beg the last months of subsistence off of their friends, family, and community. Or just sit in a corner and die, if they're not well-connected socially.
- AndrewKemendo 12y ago
  To further clarify my point though, not giving to this cause won't impact how US health care is managed, it only doesn't help this individual. If thousands of very public uninsured and preventable deaths have happened without a change this likely won't make the difference Not that abstaining is reprehensible
- nilsimsa 12y ago
  Just to let you know that with Obamacare, a few things have changed. Now if you lose coverage through your employer, you can get it through a state market for health insurance. Also pre-existing conditions are no longer allowed for consideration. But affordability may still be an issue for some.

deleted 12y ago

[deleted]

gress 12y ago

I think criticizing the US Healthcare system is perfectly reasonable. But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future.

NotOscarWilde 12y ago
> But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future. No, if you have the funds to both campaign for a systemic solution and help the individuals that are currently in trouble because of the systemic problem, then you are of course free to do so. Suggesting that one is more important of our time, energy and money than the other is, however, a valid opinion [1]. [1]: It is valid if my assumptions about the insurance not covering Jonathan and other such cases were true; that may not be so.
- gress 12y ago
  I agree that this alternative might be valid. I was merely responding to what you actually said - which was not that you were putting your resources elsewhere, but that you simply didn't want to donate to the individual.

Zarkonnen 12y ago

I have to agree. This keeps on happening: fundraisers for people in the US whose insurance is failing to cover their medical bills. Such fundraisers only work if there's a community (such as HN) to appeal to. If your path in life did not lead you into a community to fundraise from, you're just plain doomed. And I'm going to get very political for a moment here: There is a lot of enthusiasm on HN for "market forces", and a lot of hero worship of people who could build their wealth in part because things like a lack of decent healthcare make doing business in the US very cheap. I wish Jonathan Dale nothing but the best. Supporting him because he needs it is great and compassionate, but supporting him because he's One Of Us, when HN is usually so happy to cheerlead for a system that caused this in the first place? It makes me cringe.

lisper 12y ago
It shouldn't make you cringe. This is actually (part of) the whole point of Free-Market/Libertarian/Randian/Austrian/Lassez-Faire economics, that people can elect to join social groups for exactly this kind of mutual support rather than being forced to participate in a single support network run by the government. (Note: I personally don't subscribe to this theory, but it is certainly defensible.)
- Zarkonnen 12y ago
  That just makes me cringe more, sorry. Even if you don't agree with these politics, you are very much describing them in their particular language and framing: a commitment to human dignity described as a use of force.
  - Zarkonnen 12y ago
    Expanding on this: emphasis on support from the community is a mechanism to maintain the status quo. If you are part of a wealthy/powerful community, you can take risks and get the payoff. If you're not, your best bet is to try and conform and join such a powerful community - but you may not be able to. If you're the only X-believer in a community of Y-believers and you get cancer, well, it's not that the Y-believers want you to die, it's just that you're not part of their church and hence your fundraiser will get nowhere. This is not a good system.

hluska 12y ago

Unfortunately, issues like this are not confined to the United States. Both my Aunt and Stepmother are currently fighting cancer. We're Canadian, thus we have universal health care, but each province is responsible for administering its own prescription drug plan. Thus, depending on where you live and your income, you may or may not have decent coverage for cancer drugs. Complicating the situation, there is often a gap between when a drug is approved and when that drug is available for coverage. In our case, we are very lucky. Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. They're relatively lucky - they're both seniors who were well prepared and highly insured. Even luckier, they don't have dependents. I can imagine many, many circumstances under which someone with a family, even in our relatively good health care environment simply could not afford many of the drugs they need. For example, in many cases, complete drug coverage is a premium offering through private insurers. I'm not sure how many healthy people in their mid-30s would really consider premium health insurance a huge priority, especially if they have families. Rather, the tendency could be to assume that their good health will hold and they won't need insurance. In response to your valid criticism, I do agree with most of what you say. But, I would also argue that cancer is an asshole and, if I were in a situation where saving my life could bankrupt my family, I'd sure pray that my community put helping me out above making a political statement about the quality of prescription drug coverage in Canada!!

jey 12y ago
> Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. Why is it structured this way? Why don't they just directly bill the insurance without requiring large outlays upfront from the patient?
- DanBC 12y ago
  In England people pay a small amount (£8.05) for each item on a prescription. One prescription is almost always a single month. Thus, if you have 5 or so meds on a script you'll be paying £40 per month for meds. There is help for prescription costs - people can get deductions for long term meds. Luckily, most people do not pay prescription cost. About 80% of people on a prescription have some exemption or other. There are big problems with medication non-compliance, even for serious life-critical meds (cancer meds; HIV meds; transplant surgery meds) but it seems the cost (free or high cost) is not relevant - non-compliance is similar in the UK and in the US. There are some problems with the English NHS, but "getting access to meds" is not one of them. Unless you count fantastically expensive new cancer meds that add maybe a week of poor quality life.

nilsimsa 12y ago

Even with a good health insurance plan, there are still copay and deductable to consider when you have a major illness that requires hospitalization. This can add up to $1K-$4K per year of treatment depending on how good a plan you have. Then you have all the time and money incurred by your family is getting you better. Time off from work, traveling to visit you, staying with you. If you are lucky you have a good insurance plan and your employer provides disability insurance that covers your lost salary which recovering.

ma2rten 12y ago
That is exactly the point... In no other developed country (or should I say in no developed country) do people die because they can not pay their medical bills. The system has to change.
- chrisBob 12y ago
  Its actually worse than that. Preventative care is not guaranteed, but emergency care, at a hospital emergency room is. This way caring for someone with a minor illness or injury often ends up being more expensive because they can only get help when it becomes life threatening. http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html http://www.washingtonpost.com/wp-dyn/content/article/2007/02...