Another thing that struck me is that if you don`t have money, evil people can just silence you by suing you (look at those court costs, 20k and counting?!)
The discount is not guaranteed.
Aren't designed to correspond to real payments. But like a sumo wrestling match in a kindergarten, sometimes the little guy gets squashed by accident. And you wind up with people getting $20k bills that don't necessarily know how to get out from under them.
It's
I've gotten so I just ask what the out of pocket cost is to pay cheaper (usually 1/2 price), and they still manage to hose me with extra services.
It's a racket.
I want to protect from the hospital bills from something major though, like a car wreck. I'm not sure that those $50 copay per doctor visit right from the start are even available anymore. That's the insurance I had when I was a youngster.
I pay (a lot) extra for a traditional PPO and get the old-fashioned $20/$50/$75 deductible.
Dude only made around 30k per year... doing flooring, which could now kill him. Even if he could go back to his work, he had been off work for a couple months. The hospital's "reasonable payments" exceeded his income with work, and was impossible out. More common was a collection agency and eventual court date.
His way out was bankruptcy.
Totally not true. Often they'll send a collection agency.
Present company (much of the HN demographic) excepted: a fair number of HN posters are very atypical in terms of their resources for doing things like hiring lawyers.
Huge numbers, perhaps a majority, are not cool with it. We've had national elections fueled by the discontent. But at least so far the political configuration of that discontent, not the magnitude of it, has prevented progress on lowering the cost of health care.
Health insurance in this country suffers from kind of a legacy situation. It is sort of like how the qwerty keyboard is terribly inefficient, but most people continue to use it.
From what I have read, at some point health insurance was offered as a means to beef up compensation in a way that was tax friendly for employees, thus helping to entice better employees to come work for your company. This became kind of the standard default and typically covered the family, not just the employee.
This was considered a perk in a situation where most people whipped out their check book to pay for medical care because it was relatively reasonably priced. Then health insurance became kind of the default and it adds overhead and complexity. Obomacare was passed as the only politically viable solution and it's a terrible solution.
Health insurance coverage for basic services doesn't really make sense. Insurance only makes sense as a bet to defray unexpected expenses. When you use it cover annual exams and other basics that you know are guaranteed to happen, it essentially creates an unnecessary middleman, pushing prices higher without providing any real benefit for the cost involved.
This is where we are now and most people don't know how to get out of this mess. It doesn't help that Obamacare puts a gun to your head and insists that most people participate in this charade or be fined at tax time, in essence. Ugh.
The old system of paying a doctor outright with a check or cash was not a universal healthcare solution - a lot of people couldn't afford it even back then.
Most developed countries deal with the cost problems of health care through strong price regulation, even the relatively laissez-faire systems like Singapore [1] or Switzerland.
Obamacare did a lot to improve access [2] (subsidies, pre-existing conditions, adult children on parents plans) - it's a lot like the Swiss system, - but unlike that system, it did very little to address costs.
1. https://mobile.nytimes.com/2017/10/02/upshot/what-makes-sing...
2. https://www.kff.org/uninsured/fact-sheet/key-facts-about-the...
That approach of mine is frequently misunderstood and perceived to be things like making excuses or justifying the current status quo, etc.
I don't know where you get US$1k for a regular exam, but that is wrong.
My doctor, for example, charges a base (list/MSRP/whatever) rate of $120-$180 for a regular exam.
The "negotiated" rate with the insurance company is $80.
The amount I pay, as a patient, is $10.
If you don't have insurance (for a while I didn't), he charges $50.
$1k for a regular exam is fiction.
> The amount I pay, as a patient, is $10.
This is Shkreli math. "Oh, insurance companies pay larger amounts, most people will get this drug for a $10 copay!"
Oh yes, the insurance companies, those philanthropists magicking money out of ... somewhere other than your pocket, be it directly or indirectly.
As a sibling poster to you said, the ridiculous pricing is part of a game between insurers and care providers. Throwing more money at insurers might not be the ideal answer.
Is everyone against that really a "person that hates others so much"?
> we have movement in the other direction because a lot of people hate others so much they do not want them to have healthcare
Last I checked nobody was opposing healthcare discussion and debate, so the "opposing" you're talking about appears to be in reference to Obamacare. Obamacare allowing healthcare providers and insurance companies to game the system more than ever before, by providing the backing of government coffers.
One either throws money at something that "obviously won't solve the problem"[0] or one "hates people to the degree that one does not want people to have healthcare"[0].
> That viewpoint is inexcusable in my opinion
What was that you were saying about inexcusable viewpoints?
[0] Paraphrased, but sentiment remains the same.
I drew the Obamacare conclusion from the reason in my above response. Nobody is adverse to discussing healthcare solutions, so what are you talking about when you say there is a movement of hate to the degree such that people are actively rejecting the idea of others having access to healthcare?
You might try to see how some of them might (reasonably) feel that the individual mandate was removing choice from them, rather than adding it. You might try to see how some of them felt that the cost of the mandated insurance was breaking them financially. Then you might not be so quick to ascribe their motives to nothing but hate.
You could have that level of empathy and still disagree with them.
You need to remember that healthcare and education taxes are literal robbery on the rich, who never have, and never will use those services.
I'm going to say something that is controversial, and I myself haven't decided is fact, so please don't interpret it that way. Most people who work hard and are smart, can get themselves out of the lower class, regardless of their start in life (assuming they are in a first world Western country).
For reference, I live in Australia and I pay a Medicare levy (public healthcare tax). I do not have private insurance and regularly use public healthcare services. Additionally, I have been on welfare in the past. I do not believe that public health care is a Bad Thing (c), but I believe that robbing from those that have never used the services is deeply immoral.
I am not arguing for or against public healthcare. This is a difficult problem to solve. Im just trying to tell you that the decisions and opinions are not necessarily hate fuelled. If you went outside and spoke to those who disagree with you, and listened, you would see that there are reasons besides hate, that people vote the way they do. If you can see my perspective and agree with what I've written in this comment (it's a hard problem, and I'm not arguing whether healthcare is bad or not), perhaps you would consider mailing your state rep about considering a healthcare plan that is only available to the lowest earning in society, and is funded by those who required the services in the past and have "made it". Perhaps something similar to an education loan in Australia (government pays for your education, you owe them the fee plus 30% (fixed, not annual interest), paid out of a fixed % of your salary whenever you earn more than a certain amount).
While this went through my head, I just thought about the idea of bank loans for medical expenses. Why is this not a thing? The person gets their healthcare (human life value) and then they pay the bank back over time, and don't have to rob other people (anti-theft value). I am absolutely sure that I'm not the first to come up with this idea, what down-sides does this have, such that it hasn't been considered as a viable solution?
By the way, I never said anybody should die. If you had actually read my comment, you would see at least one potential solution to the problem. If somebody with 5m gets sick and the medical bills cost 10m, then they could theoretically get a medical loan which they pay back over time. They might be paying it back for the rest of their life, but at least they're not dead.
I don't have statistics that indicate one way or another about the majority of people voting against public healthcare being those that need it the most. It doesn't really make sense to me, but I'm not arguing that point so I won't debate that.
I don't know what is considered middle class in America, but in Australia, 120k household income before tax is considered basically the bottom of the middle class. I could afford private health insurance in a single income family working as a cashier. So I would question the validity of the middle class being "People who are literally one job loss, accident, or injury away from homelessness".
The problem is that you've got a two party system where groups that don't share much in common are lumped together and people are voting for the 'least worst' option. There's no reason the social and economic positions of the Democrats/Republicans have to be linked together like they are.
If they weren't, people may vote differently.
Aside from that we are all covered by the state and are not billed for anything apart from some medications. Yeah, hospitals are not that great of a place and there is a lot to be improved, but at least you know that even if you are very poor, you will not be left to die (or with some ridiculous bills) if you are very ill.
And before someone asks, why to pay for private if you have state coverage.. It is a job perk, and in any case, you pay for your time. Service is much faster and more convenient for the basic stuff/illnesses.
I'm sure lawyers charge much less there than ones in New York as well.
Now, I understand I pay taxes to cover health care. This isn't really any worse than I was paying in the states in my monthly premiums. The thing is that it creates a wonderful sort of stability in life. I can plan on taxes, I can plan on the out-of-pocket costs for a year. I won't go bankrupt. I no longer feel I'm getting ripped off for something I might have little to no control over.