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Comment by vinay427 | Hacker News Reader

About 90% of Americans overall have health insurance. Most full-time tech jobs in the US at the companies that would pay more than European salaries will include sufficient health insurance. I'm not sure who you're referring to dying in the streets because of a lack of medical treatment due to financial limitations.

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I currently have an condition that requires surgery that I'm putting off because even with my insurance (which costs me about 25% of my rent every month, or more than the total of all of my utility bills including phone and internet) it's still expensive enough that I can't do it now. This condition is the result of minor issues that I noticed nearly a decade ago, when I had no insurance, and I decided that I needed to tough it out rather than not have enough money to pay rent.

Just wanted to make this less abstract for you. Lack of insurance led to a more complex situation that underinsurance leaves me helpless to solve, while homelessness waits for me to choose health over shelter.

Well, maybe not die in the streets, but in my state the best, most expensive health insurance I can purchase still doesn't kick in until I've dropped several thousand out of pocket.

I get decent insurance through my job, but it's still fucking stupid how much I have to spend before it kicks in. Even then, there are all kinds of clauses and stipulations and loop holes. I guarantee if and when I really need my insurance it will fail me and I'll still come out in debt. There simply is not a "pay money and don't worry" insurance plan out there.

Even worse, when I go to the doctor, I have no idea what I'm going to pay. You can possible decode it, but good luck - and if he or she sends something to a lab, etc. one day a bill will just show up and you'll just have to pay it. The doctor doesn't say "we can do a lab test, it'll cost you $40" or anything. Imagine if your dry cleaner wouldn't tell you what the charge would be until your clothes had already been cleaned!

Oh, and that bill is probably gonna be full of medical coding mistakes too. Tests and procedures and all kinds of things marked up, put in the wrong category, and so forth. Expect to have to wrestle the insurance and the hospital for corrections.

I've had to do that once. I got denied short term medical insurance because they said I had diabetes (this is before Obamacare).

I've never had diabetes. I called my doctor and it turned out they coded one of my visits wrong and said I had diabetes, and it had been in everyone's system for at least a couple of years. Wonderful. Got it fixed, at least.

They do if you are a Qliance subscriber.

More and more Americans are getting stuck with High Deductible Health Plans, which for all intents don't exist until you fork over several thousand dollars to meet your deductible (excepting a limited range of "preventable care" items that are covered).

As someone without chronic expensive health needs, I've been on a HDHP with an HSA for almost a decade. They're great.

With a low deductible, I'm paying more up front so I can pay less if I need care. With an HSA and HDHP, I'm paying less for insurance and putting the difference into an interest-bearing account that I keep with me. Two different jobs that offered HDHPs also offered HSA contributions or matches.

Over time, my HSA has grown to roughly 3x my family's deductible. Tell me how I'm losing out?

As a relatively healthy young adult I'm actually a huge fan of those plans - I'd rather bank the money I would normally spend on an unused premiums into an HSA for later use. I completely recognize this is not ideal for many (most?) people and support single-payer healthcare.

Yes, but those high deductible plans have significantly lower premiums. They are usually a better deal than the copay plans, where you pay a lot more in premiums even if you never see a doctor.

The 10% of Americans who don't. The other Americans who do but still can't afford to pay what their health care doesn't cover, etc.

Even with sufficient health care, I try to avoid the doctor because of the cost.

> Even with sufficient health care, I try to avoid the doctor because of the cost.

If that is generally true then that is one really big difference between the US and northern Europe and Scandinavia. I never think of money when I or any of my family visit a doctor or hospital. Here in Norway I have to pay about USD30 to visit my GP, various fees for medical tests and so on, and I have to pay something towards any prescriptions but there is a cap on how much I will have to pay each year (about USD150 for drugs). Beyond that limit it is all free (except that of course it is paid for out of general taxation).

> I'm not sure who you're referring to dying in the streets because of a lack of medical treatment due to financial limitations.

Perhaps the GP was referring to the 10% without insurance

Employer provided health insurance is generally not worth your time, especially if you change jobs a lot. I pay for my insurance out of pocket even though my employer offers it, because I can't afford 20% copays.

90% have health insurance? Are you kidding me? I'd love to see where you pulled that figure from.

90.9%, according to the Census Bureau. See the table in this article copied from their report on Health Insurance Coverage: http://www.politifact.com/truth-o-meter/statements/2016/oct/...

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