That this shortcut to poverty by medical bills can happen in a modern western society is appalling.
The way to fix this is to measure poverty by consumption rather than income, but this is unpopular since it would reveal how little poverty really exists (eliminating an axe that politicians love to grind).
http://freakonomics.com/2011/09/14/whats-the-best-way-to-mea...
Net return on housing equity is income that you can use to buy stuff with - for example, housing in a cheaper location + other stuff. Living in an expensive locale is a consumption choice.
When someone's home equity has appreciated, they are now living in a more valuable place than they were to start, but they don't have to pay for this. That's income.
The idea of treating appreciation in home equity as income is broken, because it means that this kind of mass urbanization and consolidation appears to be an increase in income when in fact it causes a reduction in real income.
Not in any place were welfare covers those costs. There are people unable to work for life (e.g. severily injured) that still get a special pension instead of getting thrown to the streets to be homeless.
And we're not talking about "unable to work forever" either. I've had hard working friends in the united states who blew all their pension savings because of some urgent need for a few months of hospital care or some surgery. This should just not happen (and it doesn't in other places in the West).
>The way to fix this is to measure poverty by consumption rather than income, but this is unpopular since it would reveal how little poverty really exists
How about you try lowering your personal consumption to the levels you find acceptable for the "non poor", and tell us how it feels? Or, try working 2 jobs to support a child as a single mother, and tell us all about the great cushy living these people have...
http://www.amazon.com/Nickel-Dimed-Not-Getting-America/dp/03...
This idea, that poverty is some absolute value, and we should be thankful that we don't have to eat from garbage bins or live in caves really needs the Ole Yeller treatment...
I have lowered my personal consumption to US poverty levels (<$20k/year) while living in homeless shelter like conditions (minus the homeless people, aka youth hostels). In fact i enjoy it so much that I'm checking into one tonight; hello Singapore!
The idea that poverty is not some absolute value is kind of crazy - if we solve all this kid's current problems but give other people flying cars and robots (maintaining his relative position), will he still be unable to finish school?
Also, why do you bring up a highly non-representative example (a person working full time) to personify poverty? Why not choose a far more representative person, like someone not working at all or even seeking work?http://www.epi.org/publication/poor-people-work-a-majority-o... http://www.bls.gov/opub/reports/cps/a-profile-of-the-working...
Kind of crazy? That has been the idea for millennia, being poor has never been about specific, fixed in time, living conditions. Poor vs rich is a monetary worth issue, not a "does he have a cellphone" issue, and issues of worth are relative. It's the same "relative poorness" that's behind a guy making $15k a year considered poor in the US and frigging rich in Somalia.
>if we solve all this kid's current problems but give other people flying cars and robots (maintaining his relative position), will he still be unable to finish school?
No, he'll be able to finish school alright (and nobody argued against that).
But he'll still be poor though compared to the people with flying cars and robots. And if success in that society is helped by having access to such things, he'll still be behind his peers that have that access.
Same way that if a guy that cannot afford a car has been given a place to stay, he has solved his homelessness problem, but cannot as easily find a job since he only has access to nearby jobs that don't require commuting.
>Also, why do you bring up a highly non-representative example (a person working full time) to personify poverty? Why not choose a far more representative person, like someone not working at all or even seeking work?
The very title of the first article you linked to is: "A Majority of Poor People Who Can Work Do". As the article itself says, 44.3 percent of the "poor people" are "working full-time". That's why I brought up "a person working full time" to personify poverty.
Sure, it's even worse for those who can't find a job, or can only find a part time job. But at least with a poor person working full time the standard BS arguments that one can say about an unemployed poor person ("he's just lazy etc") doesn't even register in the first place.
Note also how that source defines "eligible to work" to get that 44% number (by excluding students/age >64/disabled, many of whom could be working). The single mother working 2 jobs is not even representative of this narrowly defined "eligible to work" category.
If you had said that you went into a walk in clinic I would expect a much lower service cost. You went into the same place that is perpetually prepared for a mass casualty scenario and received that level of service. Insurance has us so disconnected from healthcare service costs its easy to think everything should cost the same as the local mechanic or lawn care service.
My wife was in a bed for 3 of the 4 hours, seen by two nurses for maybe 1 of those hours total, and the doctor for barely 30 minutes while she took a large dose of her standard drug that we get over the counter for $20 a month. I'm not saying people shouldn't get paid, but two thousand dollars? And that's AFTER insurance, by the way.
A collision specialist will charge a greater rate for services than a local tire shop because; the tooling is greater and the staff skill levels are greater.
>two thousand dollars? And that's AFTER insurance, by the way
You never mentioned that this was after insurance. If your bill was vastly more than $2,000 - I can agree that we have a cost issue (stemming from insurance interference in the marketplace).
I can't tell if you're clinging to this argument out of pride or if you're just deliberately refusing to understand what "emergency" care is for some reason. Maybe you haven't had the experience of dialing up a significant other's parents to let them know what's going on and which hospital you're going to in the middle of the night, but let me tell you that planning out which hospital was going to screw us the least in the pocketbook was NOT in the forefront of my mind.
Edit: Full disclosure, this was the best case scenario: In network hospital and everything. I research this stuff ahead of time for this exact reason. The insurance company only covers 60% of the visit until I spend something like $4,500. When you make under $40k, $2,000 might as well be $4,500 might as well be a million dollars, it DOESN'T MATTER because it's still going to ruin you for a long time.
I can only imagine how silly you are trying to be!
This has been well documented and studied time and again.
It's not like Sweden or Denmark have much worse hospitals or doctors -- on the contrary, even a crappy US hospitalization will cost you several times more than what it would cost you there.
Heck, I was taken into a first class private hospital in an (advanced) Asian country, stayed there for the night, was taken care of by 4 nurses, had several exams/tests made, was consulted by 2 doctors, oh, and they even got me there by ambulance after a friend called (I had fainted atm).
I expected the worst, but the next day I was asked to pay something amounting to $50 -- without even having an insurance coverage (as I was just visiting).
The treatment can be relatively simple, but in those cases you usually don't go to the ED to begin with: an in-home nebulizer device costs a few hundred dollars (uninsured) and pays for itself by saving only one ED trip (even if insured). The exception, naturally, is if your asthma is undiagnosed or usually not problematic, or if you run out of medication and need more in a hurry.
If it goes beyond that, the patient will often require intravenous medication, which a typical walk-in clinic is not equipped to administer. Even if the attack is obliging enough to occur when the clinic is open, all they will do is send you to the nearest emergency department.
The most severe attacks will require EMTs on-site, because the patient could easily die before reaching the hospital. One sometimes goes to the hospital in cases where one fears it will escalate to this as a simple preemptive, because if it goes badly you die.
It's true that there is a cost to handling all of this, and that needs to be understood. Still, it's worth remembering that this isn't some frivolous waste of resources: said resources are being applied to a legitimate need. The alternative is not to accept a lesser "level of service", it is to accept a nontrivial risk of dying of suffocation.
An asthma attack that cannot be controlled by the kind of self-administered drugs usually prescribed to asthmatics (or experienced by someone who does not have those drugs) is a life-threatening emergency; walk-in clinics are not not set up to handle them, will likely send you out to an ER if you present with one, and are often not open when they occur.
Even combined HMO/provider entities like Kaiser (who are footing the bill themselves, and don't get more money if you take a method that incurs greater costs) will, if you call their advice line with such an attack, direct you to the ER.